器官移植

Abstract:
Objective To investigate the effect of infusion of spleen lymphocytes treated by extracorporeal photochemotherapy on the regulatory T cell (Treg) and survival time of skin allograft in mice. Methods The skin allograft model in mice was established with C57BL/6 mice as donors and BALB/c mice as recipients. The spleen lymphocytes (CSP, BSP) in mice C57BL/6 and BALB/c were isolated, and the mice spleen lymphocytes (PUVA-SP) treated with 8-methoxypsoralen plus ultraviolet (PUVA) were prepared. The experimental animals were randomly divided into 5 groups according to the compositions infused into the recipients through vein: PUVA-BSP, PUVA-CSP, BSP, CSP and phosphate buffer solution (PBS) control groups (n=12 in each group). All recipients of each group were injected with PUVA-BSP, PUVA-CSP, BSP, CSP or PBS on day 7 before the operation, on the operation day and day 7 after the operation through the tail vein, respectively. The survival time of graft in the recipients was observed, and the expression of CD4⁺CD25⁺Foxp3⁺Treg in peripheral blood was detected. Results After skin allograft, the rate of CD4⁺CD25⁺Foxp3⁺Treg in peripheral blood of the recipients in PUVA-BSP group and PUVA-CSP group was significantly higher than those of BSP, CSP and PBS control groups. The rate of CD4⁺CD25⁺Foxp3⁺Treg in PUVA-CSP group was higher than that of PUVA-BSP group, while BSP and CSP groups were lower than that of PBS control group. The survival time of skin graft in the recipients in PUVA-BSP group and PUVA-CSP group was significantly longer than that of BSP, CSP and PBS control groups (all P < 0.05). Conclusions Sufficient infusion of PUVA-SP can induce more CD4⁺CD25⁺Foxp3⁺Treg in the recipients and prolong survival time of skin graft significantly.

Changes of renal resident dendritic cells during kidney ischemia-reperfusion injury

Yao chen, Li Shuxin, Yu Tao, Xu Xiaodong, Shi Bingyi

2016, 7(5): 360-364. doi: 10.3969/j.issn.1674-7445.2016.05.006

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Abstract:
Objective To investigate the changes of renal resident dendritic cells (rDC) during kidney ischemia-reperfusion injury(IRI). Methods C57BL/6J mice models with bilateral renal warm ischemia were established. The kidney tissue was prepared for single cell suspension at 24 h and 48 h after reperfusion. The changes in the percentage of CD45⁺ cells and CD11c⁺rDCs were evaluated by flow cytometry. The renal tissues of mice labeled with green fluorescent protein and diphtheria toxin receptor (CD11c⁺GDTR) were prepared for single cell suspension. The percentage and phenotype of CD11c⁺rDCs were analyzed by flow cytometry. CD11c⁺GDTR mice models with bilateral renal warm ischemia were established. The renal tissue was prepared for single cell suspension at 24 h after reperfusion. CD45⁺ cells was gathered by magnetic-activated cell separation (MACS). The expression levels of co-stimulatory molecules on the rDC surface were analyzed by flow cytometry. Results At 24 h after reperfusion, the percentage of CD45⁺ cells in the kidney of C57BL/6J mice was significantly elevated, and further increased at 48 h after reperfusion. At 24 h after reperfusion, the quantity of CD11c⁺rDCs was equally increased, whereas the percentage of CD11c⁺rDCs in CD45⁺ cells was dramatically declined and restored at 48 h after reperfusion, slightly higher compared with that in the sham group. In healthy CD11c⁺GDTR mice, the percentage of CD45⁺ cells in the kidney was lower than 1%, consisting of approximately 40% of CD11c⁺rDCs, which mainly presented as CD11b^intF4/80^-MHCⅡ⁺. At 24 h after reperfusion, the percentage of CD11c⁺F4/80^- subset rDC surface co-stimulatory molecules was significantly enhanced, such as CD40, CD80 and CD86. Conclusions Following warm IRI, the percentage and quantity of rDCs, and the expression level of rDC surface co-stimulatory molecule are significantly increased, prompting that renal rDC infiltration is increased and phenotype becomes matured.

Effect of permissive hypercapnia on CD4⁺ and CD8⁺ T cells of rats with acute rejection after lung transplantation

Wang Ling, LaBudanbaila

2016, 7(5): 365-369. doi: 10.3969/j.issn.1674-7445.2016.05.007

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Abstract:
Objective To investigate the effect of permissive hypercapnia on CD4⁺ and CD8⁺ T cells of rats with acute rejection after lung transplantation. Methods Twenty-four male Wistar rats and 12 male SD rats were paired and randomly divided into 3 groups (6 pairs per group). SD and Wistar rats were used as the donors and recipients in the control group and treatment group, respectively, and Wistar rats were used as the donors and recipients in the allograft group. Acute rejection rat model of orthotopic left lung transplantation was established by Cuff method. The treatment group was treated with 50% oxygen and 8% carbon dioxide after reperfusion, but only 50% oxygen for the control group and allograft group after reperfusion. Expressions of CD4⁺ and CD8⁺T cells in transplanted lung tissue were detected with immunohistochemical (IHC) method on 7 d after the operation. Proportion of CD4⁺ and CD8⁺T cells in peripheral blood was detected with flow cytometry. Furthermore, levels of interleukin (IL)-2 and interferon (IFN)-γ in peripheral blood were detected with enzyme-linked immune absorbent assay (ELISA). Results The IHC results showed that, compared with the control group, the expression of CD8⁺T cells in transplant lung tissue of rats decreased significantly in both the treatment group and allograft group. The results of flow cytometry showed that compared with the control group, the proportion of CD8⁺T cells decreased significantly in both treatment group and allograft group (both P < 0.05). ELISA results showed that, compared with the control group, levels of IL-2 and IFN-γ decreased significantly in both treatment group and allograft group (both P < 0.05). Conclusions Permissive hypercapnia can inhibit the acute rejection after lung transplantation through inhibiting the proliferation of CD8⁺T cells and release of inflammatory cytokines in CD4⁺ T cells.

Editorial

Research status and progress on tuberculosis after solid organ transplantation

2016, 7(5): 351-354. doi: 10.3969/j.issn.1674-7445.2016.05.004

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Clinical Researches

Meta analysis of therapeutic effects on patients with ABO-incompatibility liver transplantation

Dong Hongmeng, Dai Yang, Zhang Xinxue, Zhang Duoxian, Bai Chun, Li Xianliang, He Qiang

2016, 7(5): 370-377. doi: 10.3969/j.issn.1674-7445.2016.05.008

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Objective To systematic evaluation the therapeutic effects on patients with ABO-incompatibility liver transplantation (ILT), and compare the curative effect with ABO-compatible liver transplantation (CLT). Methods The literatures of comparison in clinical efficacy between ILT and CLT were collected at home and abroad by computer search in PubMed database, Embase database, Cochrane database, Medline database, Web of science database, CNKI, Wanfang database, VIP database, et al, and the quality of literatures were accessed. Meta analysis was carried out by fixed effect model and random effect model with RevMan5.3 software. Results A total of 18 papers were included. The results of Meta analysis showed that there was no significant difference in the survival rates of recipient between ILT group and CLT group at 1, 3 and 5 years after operation (all P > 0.05). Compared with CLT group, the survival rates of grafts were significantly decreased in ILT group at 1, 3 and 5 years after operation, and the difference was statistically significant (all P < 0.05). The incidences of postoperative biliary complication and acute rejection in ILT group were significantly higher than those in CLT group, the difference was statistically significant (both P < 0.05). Conclusions Compared with CLT, the curative effect of ILT is weaker but still can be used as a new choice for critical condition of the recipient or waiting for the donor liver for a long time.

Effect of devascularization and shunt on liver transplantation in patients with portal hypertension

Meng Wei, Zhao Hui, Zhang Tong, Fu Binsheng, Wang Guoying, Yi Shuhong, Xu Chi, Wang Genshu, Li Hua, Yang Yang, Chen Guihua

2016, 7(5): 378-381. doi: 10.3969/j.issn.1674-7445.2016.05.009

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Objective To evaluate the influence of devascularization and shunt on liver transplantation in patients diagnosed with portal hypertension. Methods Clinical data of 182 patients diagnosed with cirrhosis, portal hypertension complicated with hemorrhages caused by esophageal and gastric varices rupture undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University from January 2007 to December 2011 were retrospectively analyzed. Nineteen patients undergoing splenectomy plus pericardial devascularization were assigned into the devascularization group, 5 receiving distal spleen-renal vein shunt into the shunt group, and the remaining 158 cases with no history of devascularization or shunt into the control group. Preoperative incidence of pylethrombosis, operation time, intraoperative hemorrhage volume, the maximal blood flow velocity (V_max) of portal vein anastomotic stoma at postoperative 1 month, postoperative incidence of pylethrombosis and 3-year survival rate were statistically compared among three groups. Results In the devascularization group, preoperative incidence of pylethrombosis was significantly higher compared with that in the control group(P < 0.01). Compared with the control group, operation time of liver transplantation in the devascularization and shunt groups was significantly longer (both P < 0.05). The incidence of pylethrombosis at postoperative 1 month was considerably enhanced in the devascularization group (P < 0.05). The 3-year survival rates of devascularization group and shunt group were dramatically decreased compared with that of control group (both P < 0.05). Intraoperative hemorrhage volume and V_max of portal vein anastomotic stoma did not significantly differ among three groups (all P>0.05). Conclusions The medical history of devascularization or shunt will not cause severe difficulty or surgical risk to subsequent liver transplantation in patients with portal hypertension.

Correlation of tumor recurrence after liver transplantation for hepatocellular carcinoma with the expression levels of regulatory T cells and cytokines in peripheral blood

Yang Shaozhen, Zhou Lin, Du Guosheng, Song Jiyong, Zhu Zhidong, Feng Likui, Suo Longlong, Zheng Yonggen

2016, 7(5): 382-385. doi: 10.3969/j.issn.1674-7445.2016.05.010

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Objective To analyze the correlation of tumor recurrence after liver transplantation for hepatocellular carcinoma(HCC) with the expression levels of regulatory T cell(Treg) and cytokines in peripheral blood. Methods A total of 56 patients who underwent liver transplantation in the 309^th Hospital of People's Liberation Army from 2010 to 2014 were studied. According to the postoperative pathological data, all the patients were divided into the group of liver transplantation for HCC (HCC group, n=28) and group of liver transplantation for cirrhosis (liver cirrhosis group, n=28), of which the HCC group was further divided into non-recurrence group (n=8) and recurrence group (n=20) according to the situation of postoperative tumor recurrence. The expression levels of Treg and cytokines [vascular endothelial growth factor (VEGF), interleukin (IL) -2, IL-10, IL-12, transformation growth factor (TGF) -β and interferon (IFN) -γ] in peripheral blood of the patients in various groups were compared. Results Compared with the liver cirrhosis group, levels of IFN-γ and IL-12 in the non-recurrence group increased significantly (both P < 0.05); levels of Treg%, VEGF, IFN-γ, IL-10 and TGF-β in the recurrence group increased significantly, while levels of IL-2 and IL-12 decreased significantly (all P < 0.05). Compared with the non-recurrence group, levels of Treg%, VEGF, IL-10 and TGF-β in the recurrence group increased significantly, while levels of IFN-γ, IL-2 and IL-12 decreased significantly (all P < 0.05). Conclusions Levels of Treg and cytokines can be used to predict the tumor recurrence after liver transplantation for HCC.

Effect of anti-HLA antibody detected by Luminex testing on clinical prognosis of renal transplantation recipients

Lin Hua, Chen Jiejing, Chen Huaizhou, Mo Qiuju, Sui Weiguo

2016, 7(5): 386-389. doi: 10.3969/j.issn.1674-7445.2016.05.011

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Objective To investigate the value of anti-human leukocyte antigen (HLA) antibody level detected by Luminex testing in predicting clinical prognosis of renal transplantation recipients. Methods A total of 1 105 patients scheduled to undergo renal transplantation (354 successfully undergoing renal transplantation) in the 181^st Hospital of Peoples Liberation Army from June 2013 to November 2015 were selected. The serum samples were collected from 1 923 cases before and after renal transplantation. The positive rate and fluorescent intensity of anti-HLA antibody were detected by Luminex testing before and after renal transplantation. The renal function of recipients was also evaluated after renal transplantation. Results Prior to renal transplantation, 51.0% (546/1 071) of serum samples were positive for anti-HLA antibody, including 26.0% (279/1 071) positive for anti-HLA Ⅰ antibody, 24.9% (267/1 071) positive for anti-HLA Ⅱ antibody and 11.4% (122/1 071) positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies. Among 354 patients undergoing renal transplantation, 59 (17%) were positive for anti-HLA antibody after renal transplantation, including 25 (4 newly positive after surgery) positive for anti-HLA Ⅰ antibody, 15 (1 newly positive after surgery) positive for anti-HLA Ⅱ antibody and 19 (4 newly positive after surgery) positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies. During subsequent follow-up, 13 patients positive for anti-HLA Ⅰ antibody, 5 positive for anti-HLA Ⅱ antibody and 11 positive for both anti-HLA Ⅰ and anti-HLA Ⅱ antibodies developed transplant kidney dysfunction. All patients newly positive for anti-HLA antibody after renal transplantation presented with transplant kidney dysfunction. Conclusions Luminex testing can perform dynamic detection of the positive rate of anti-HLA antibody, which is important in predicting clinical prognosis of recipients after renal transplantation.

Review Articles

2016, 7(5): 390-393. doi: 10.3969/j.issn.1674-7445.2016.05.012

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2016, 7(5): 394-398. doi: 10.3969/j.issn.1674-7445.2016.05.013

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