摘要:

The utility of bile cytology (BC) in the diagnosis of hepatic graft rejection was assessed in 21 liver trans plantations in 18 patients. A total of 307 BC specimens were studied; cell density and relative contribution of different cell types were monitored in 130 specimens. The findings in 62 fine-needle aspiration biopsies and 9 core needle biopsies (CNB) from the transplants were compared with those of the BC specimens.For the first 3–5 days after transplantation, BC specimens were cell-rich, containing degenerating cells and polymorphonuclear leukocytes. In uneventful cases, the cellularity of the specimens gradually decreased. Upon rejection, the number of cells increased, with a high percentage of PMN. Occasionally, blasts or macrophages were detected. After antirejection treatment, the cellularity of the specimens decreased. The analysis of the relationship between the findings of BC and FNAB showed that a high cell density was indicative of rejection. However, BC was not as sensitive to rejection as was FNAB. No clear-cut correlation was found between BC pattern and the degree of cell infiltration in portal triads as seen in CNB specimens. Our results indicate that serial bile cytology is valuable as an additional diagnostic method in monitoring hepatic graft rejection.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

We present a case report of a pediatric orthotopic liver transplant recipient who developed lymphoma with hypercalcemia on cyclosporine and prednisone immuno-suppression. This is the first reported posttransplant lymphoproliferative disorder complicated by hypercalcemia, with a finding of an elevated 1,25 dihydroxyl vitamin D state, suggesting that it has a role in the pathophysiology of this B cell lymphoma hypercalcemia. The clinical course and management of this disorder with a 31-month follow-up are described.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The relationship between central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) and serum sodium changes in the setting of orthotopic liver trans plantation (OLT) is examined. Postmortem examination of 14 patients with end-stage liver disease who under went liver transplantation revealed CPM in four, of which three also had EPM. A retrospective review of clinical and laboratory data was performed on all patients. There were marked perioperative rises (21–32 mEq/L) in the serum sodium concentration in all four patients who developed myelinolysis. In contrast, the largest increase in sodium in patients without demyelination was 16 mEq/L. We conclude that perioperative rises in the serum sodium concentration increase the risk of myelinolysis. CPM and EPM should be considered if the patient develops mental status changes or focal neurological deficits several days after OLT.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A pilot study was performed to explore the clinical potential of Leu2a antibody in reversing acute renal allograft rejection. Anti-Leu2a, a murine IgGi monoclonal antibody (mlgGi mAb), is specific for the CD8 molecule that is expressed in high density on class I reactive T cells. Of the 6 recipients treated with anti-Leu2a, two responded with a complete reversal of rejection with long-term allograft function maintained for over a year. In two other recipients, acute rejection was initially reversed, but later rejection episodes resulted in allograft failure at 2–3 months posttreatment. Rejection in the two other recipients showed no response to Leu2a mAb treatment. Specific depletion of peripheral blood CD8+cells occurred in four of the six recipients. Even in this small series, it was evident that cell clearance

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Embryonic DA retinal allografts that have survived for prolonged periods after having been transplanted into the brains of neonatal BN rats can be induced to reject following peripheral sensitization with a DA skin graft. The results show that histocompatibility antigens play the major role in the rejection of grafts placed in the CNS and that a disparity between the retinal and skin grafts for MHC antigens induces a more severe rejection response than does a non-MHC antigen disparity.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The cells expressing MHC class II antigens play an important role in allograft rejection. We examined the expression of HLA DR antigens in human fetal pancreata ranging in gestational ages from 8 to 24 weeks. DR antigens were detected by immunohistochemical techniques using H4 and 40D MoAbs with immunoper-oxidase staining and the ABC procedure. Vascular en-dothelium was identified by goat antibodies directed to human factor VIII—related antigens. DR expression on endothelium was further confirmed by double staining of tissue sections with H4 and anti-FVIII antibodies. In pancreata younger than 18 weeks of gestation, DR antigens were found on single cells that were randomly distributed throughout the pancreatic parenchyma. These cells resembled dendritic cells in morphology, as reported previously (1, 2). Some vascular endothelial cells located in the intralobular connective tissues ex pressed DR antigens, but those in the pancreatic parenchyma were DR-negative. In 18–22 weeks, some endothelia of small vessels in the parenchyma became DR-positive. By 24 weeks, DR antigens were also expressed on medium-sized blood vessels, whereas intraislet capillaries and duct epithelia were DR-negative. The number of DR-positive cells increased rapidly from 11.2 cells/field (x400) in 12–14 week pancreata to 42.8 cells/field in 18–22 week pancreata. Most DR-positive cells in pancreata earlier than 18 weeks were dendritic-like cells, while those in older pancreata were endothelial cells. When pancreatic tissue fragments were cultured for two days in the presence of rIFN-γ, vascular endothelium and duct epithelium, both of which were other wise DR-negative, had become DR-positive. Even with this increase, DR-positive cell numbers were fewer in pancreata younger than 18 weeks of gestation as com pared with those in older pancreata. We also detected clusters of epithelial-like cells that were clearly stained for DR antigens. These cells were located in the parenchyma where insulin positive cells were generally found. Their DR-antigens had not changed during the 3-day rIFN-γ culture.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Long-term bone marrow cultures (LTBMC) were initiated with marrow aspirate cells from 12 patients with multiple myeloma (MM) using the Dexter system. The myeloid and the neoplastic myeloma cell growths were evaluated for up to 6–9 weeks. Our results demonstrate the development of an adherent layer capable of sup porting normal granulopoiesis with a concomitant drop in the growth of myeloma cells. The B lymphocyte monoclonal proliferative compartment was also studied with bromodeoxyuridine (Brdurd), an analog of thymidine incorporated during the S-phase, and the labeling index was calculated. The ability to form myeloma stem cell colonies in a modified plasma clot short-term assay was also evaluated.The results confirmed that the neoplastic B lineage compartment was not able to grow in Dexter's system for more than 4 weeks in 11 of 12 cases studied, with the disappearance of Brdurd-positive cells after two weeks, whereas LTBMC were able to sustain the growth of myeloid progenitors. These data indicate the potential applicability of this culture method in selecting normal hematopoietic progenitors from patients with multiple myeloma. This approach can have significant implications for aggressive treatment of patients with multiple myeloma, especially in trials involving autologous bone marrow transplantation (ABMT).

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Water-soluble classical (RT1-A) class I MHC molecules were purified from aqueous extracts of DA strain liver. Following monoclonal antibody affinity, lentil lectin affinity, and gel filtration chromatography, 600 μg of soluble RT1-A class I molecules with antigen activity equivalent to 1.3×1011nucleated DA spleen cells (>500 DA spleens) was obtained. Both PVG and LEW strain recipients of DA kidney allografts were pretreated with intravenous injections of the DA soluble class I molecules, in doses with antigen activity equivalent to 108nucleated DA spleen cells. Three protocols of pretreatment were used: twice-weekly injections for 4–5 weeks, with grafting 3 or 4 days after the last injection; a single injection 7 days pregraft; or a single injection 1 day pregraft. The PVG and LEW rats received the soluble class I pretreatment either alone or in combination with suboptimal doses (2 mg/kg/day) of cyclosporine after grafting, making a total of 12 experimental groups treated with soluble class I antigen. In no case did treatment with soluble class I antigen elicit an antibody reponse in prospective graft recipients; influence kidney graft survival in any way; or enhance or suppress the antibody response to the kidney graft.The soluble DA class I MHC molecules were tested in vitro for their effect on the generation and effector function of allospecific PVG and LEW anti DA RT1-A class I cytotoxic T cells and TNP specific, self RT1-A restricted cytotoxic T cells. Concentrations up to 5 μg/ml (10−7M), equivalent to 109nucleated DA spleen cells/ml, were without any efffect.We conclude that monomeric forms of water-soluble classical class I molecules are poor immunogens—and, at doses conventionally used for active enhancement, do not influence cytotoxic T cell responses and have little potential for donor-specific immunosuppression.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The present study was initiated to study the efficacy of donor pretreatment with interferon-γ to induce class II antigen expression in heart tissue, and to investigate whether this pretreatment would influence heart allograft survival. BN rats were used as donors, and LEW rats as recipients. During a period of 3 consecutive days prior to transplantation, IFN-γ was administered to BN rats via continuous intravenous infusion at dosages of 10, 10, and 5.10 U/hr. Control animals were infused with PBS; each group consisted of 9 animals. Analysis of IFN-7induced class II expression by immunoperoxidase staining revealed a significant, fourfold increase in the number of dendriticlike cells, irrespective of the IFN-γ dose given (controls: 15±4 vs. highest dose group: 57±9cells/mm;P< 0.005). Endothelial cells of arteries and venules remained class II antigen negative. Grafting of hearts from IFN-γ perfused donors to untreated recipients (6 animals per group), did not result in a shortened or prolonged survival time in any of the experimental groups, as compared to controls. These results indicate that upgrading of class II antigen expression on dendriticlike cells is not likely to be of importance for the process of rejection.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Syngeneic graft-versus-host disease has been shown to occur in syngeneic rat radiation chimeras after treatment with a short course of CsA. However, data concerning this model have been controversial in murine systems. We have successfully induced a GVHD-like syndrome in syngeneic mouse radiation chimeras treated transiently with CsA. Lethally irradiated (950 rads) DBA/2 mice were reconstituted with syngeneic bone marrow and treated daily, i.p. with 15 mg/kg CsA in olive oil for 21 days. Within 1 week after discontinuing CsA, animals developed clinical signs of GVHD including runting, hunched posture, and severe diarrhea. This disease was fatal for greater than 80% of treated animals within 4 weeks after cessation of CsA. Furthermore, the induction of syngeneic GVHD did not appear to be linked to a particular MHC haplotype. Histologically, there was pronounced lymphoid atrophy of the spleen and thymus. Sections of large intestine showed an acute inflammatory process involving the mucosal layer ranging from single-cell destruction to complete mucosal ulceration. This murine model of GVHD should provide new opportunities for studying the development and regulation of autoimmune processes.

ISSN:0041-1337    

出版商:OVID    

年代:1989

数据来源: OVID