GVHR IN COMBINED SMALL BOWEL AND LIVER TRANSPLANTATION

选用体重200~300g的纯种雄性Lewis(LEW)和Lewis XBrown挪威杂交F1(LBNF1)大鼠。采用Monchik和Russel技术进行异位小肠移植。在第一部分的研究中，对移植物中的淋巴细胞进行了示踪。在腹腔注射溴脱氧尿苷(BrdU)20 mg后，将小肠作为移植物进行解剖。GVHR组以LEW大鼠为供体，LBNF1大鼠为受体，进行异位小肠移植。移植后第5天处死动物。取自然肠道的粘膜标本和肠系膜淋巴结。切片用ABC法染色。采用抗Br-Du抗体和淋巴细胞表面抗标记物(W3/13)。在第二部分实验中，动物分为两组，观察免疫细胞动力学。第一组为异体移植组，作为对照。LBNF1 ra…更多的T充当捐赠者和接受者。第二组为排斥组。LBNF1大鼠为供体，LEW为受体。第三种是GVHR。LEW大鼠为供体，LBNF1大鼠为受体。在给药后第8天处死动物，给药20 mg。用流式细胞仪检测Peyer氏斑和肠系膜淋巴结的BrDu标记指数和DNA合成时间。我们发现GVHR的自然肠系膜淋巴结标本中有一些从移植物中迁移的BrDu阳性淋巴细胞。移植物抗宿主病患者淋巴结中W3/13阳性细胞显着增加，这些同种异体T淋巴细胞被激发并产生针对天然肠道的免疫反应。BR-DU标记指数和DNA合成时间显示移植物的淋巴系统受到刺激，而天然肠的淋巴系统受到强烈抑制，提示GVHR中天然肠粘膜的弥散屏障功能减弱。这会导致细菌和抗原闯入门静脉系统，有时还会导致受体患上败血症。小肠和肝联合移植可有效降低小肠移植物的抗原性。较少

Purebred male Lewis (Lew) and LewisXBrown Norway F1 hybrid (LBNF1) rats weighting 200-300 g were used. The heterotopic small bowei transplantation was carried out using the technique of Monchik and Russel. For the first part of investigation, the tracing of lymphatic cells from grafts was performed. The small bowel was dissected as a graft after intra-peritoneal injection of 20 mg of bromodeoxyuridine (BrdU). The heterotopic small bowel transplantation was carried out in GVHR group (Lew rats served as doner, and LBNF1 rats as recipient). The animals were sacrificed on the fifth day after transplantation. The mucosal specimens and mesenteric lymph nodes from the native intestine were obtained. The sections were stained with ABC method. Anti-Br dU antibody and anti-surface markers of lymphocytes (W3/13) were used.For the second part of investigation, the animals were divided in two groups to investigate the immunological cell kinetics. The first was iso graft group as a control. LBNF1 ra … More ts served as doner and recipient. The second was rejection group. LBNF1 rats served as doner and Lew served as recipient. The third was of GVHR. Lew rats served as doner, and LBNF1 rats as recipient. The animals were sacrificed on the eighth day after administration of 20 mg of Br dU. Br dU labelling index and DNA synthesis time of both Peyer's patch and mesenteric lymph node were examined with flowcytometer.We documented that the specimens from the native mesenteric lymph nodes include some Br dU positive lymphocytes that immigrated from the graft in GVHR. There was a marked increase of W3/13 positive cells in lymph nodes in GVHR These allogenic T lymphocytes become stimulated and develop an immune response against the native intestine4). We also documented that the Br dU labeling index and DNA synthesis time demonstrated that the lymphatic system of the graft was stimulated, but those of the native intestine was strongly suppressed in GVHR.These findings suggest that the diffuse barrier function of the mucosal linigs of the native intestine had weakened in GVHR. This results in bacteria and antigens breaking into the portal system, and sometimes causing recipients to develop a septic condition. The combined (small bowel and liver) transplantation may be useful for small bowel transplantation to decrease antigenesty of small bowel graft. Less