ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

A 47-year-old patient with blood group O inadvertently received a mismatched kidney from a donor of blood group A. Two days after transplantation, the clinical, biochemical manifestation of an intrarenal, intravascular coagulation was seen. This was treated by plasma exchange with the rapid reversal of all parameters, and reduction of both the IgG and IgM component of the circulating anti-A antibody. The patient, 20 months after transplantation, has normal renal function. Subsequent repeated biopsies have shown no recurrence or manifestation of the effects of the intravascular coagulopathy.This case report documents, for the first time, the reversal of the known deleterious effects of major blood group incompatibility on renal transplantation by the use of a new technique, modified plasmapheresis. Furthermore, it implies that the limitation of transplantation of kidneys on the basis of major ABO blood groups may not be justifiable in all instances.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Very small amounts (0.5 to 2 μl) of H-2-incompatible blood given 16 days before skin grafting led to the induction of a long-lived unresponsiveness when the mice were given a short postoperative course of alternating doses of procarbazine hydrochloride and antilymphocyte serum. This unresponsiveness, which was specific for the blood donor strain, was wholly attributable to the white cell moiety, plasma and red blood cells having proved to be ineffective. The optimal dose range of white blood cells was fairly narrow (7 × 103to 1.4 × 104). Of the various attempts made to demonstrate that the blood inoculum modified the response of normal mice, only direct skin grafting gave a positive result in that the survival of allogeneic skin grafts was curtailed. Mixtures of blood from several mouse strains injected into CBA recipients induced long-term unresponsiveness to skin grafts of the blood donor strains. However, although it was possible to create unresponsiveness to DBA/2, C57B1, or strain A skin grafts in CBA mice pretreated with blood from a closed colony outbred strain (TO), this pretreatment had no beneficial effect on the survival of TO skin grafts. Likewise, TO blood failed to induce unresponsiveness to TO skin grafts in TO recipients. It is argued that these findings are not necessarily inconsistent with the observation that, in inbred animals, the induction of unresponsiveness was strain specific.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

After heterotopic pancreatic allotransplantation in dogs and in the absence of rejection there was a fasting normoglycemia with a marked hyperinsulinemia. On intravenous glucose tolerance testing and intravenous glucagon testing, the blood sugar response of dogs receiving no immunosuppression was normal but the response in dogs receiving immunosuppressive therapy was exaggerated. There was a marked increase in the insulin response compared with normal animals whether or not immunosuppressive therapy was administered. The first endocrine event during allograft rejection seemed to be a drop in the pancreatic insulin reserve as demonstrated by plasma insulin results during a glucagon test; occurring 2 to 3 days before clinically overt rejection. This was also found on glucose tolerance testing. A rise in the fasting plasma insulin occurred next, 1 to 2 days before a rise in the fasting blood sugar. As the rejection process progressed, the plasma insulin levels subsequently dropped until the death of the animal.If, during a rejection process, the blood sugar did not rise above 150 mg/100 ml and the plasma insulin level did not drop below the lower limit of normal the rejection was usually reversible with intravenous methylprednisolone.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Pancreatic endocrine function was investigated in dogs after heterotopic pancreatic allotransplantation. A marked hyperinsulinemia was found in peripheral venous blood within the first 60 min postoperatively. This was associated with hypoglycemia and hypokalemia occurring within the next 2 to 3 hr resulting eventually in death. The hypoglycemia and hypokalemia could be corrected by parenteral dextrose and potassium given during the first 2 hr postoperatively or prevented by parenteral hydrocortisone given at the time of transplantation.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

After pancreatectomy and heterotopic pancreatic allotransplantation in dogs, there was a pattern of endocrine activity similar to that found following a combination of pancreatic denervation and total transposition of the pancreatic venous effluent from the portal to the systemic venous circulation. Denervation of the pancreas alone or total venous transposition alone did not mirror these results. The mechanism of the effect of these two factors is discussed.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

The effects of several widely used lymphoid ablative procedures designed to deplete rats of T lymphocytes have been examined. These studies emphasize both the distribution of T and B lymphocytes in individual host lymphoid compartments and the survival of cardiac allografts in recipients modified by various means. Adult thymectomy reduced the numbers of T lymphocytes in the thoracic duct (TD) and lymph nodes and to a lesser extent in the spleen, but did not alter circulating T cell numbers or cardiac graft survival. TD drainage performed alone or in combination with adult thymectomy reduced circulating T cells but did not prolong graft survival. In contrast, indefinite cardiac survival occurred in “B” rats, animals undergoing adult thymectomy, total body irradiation, and reconstitution with syngeneic bone marrow cells from TD-drained donors. However, B rats were not only profoundly depleted of T cells but also of B cells. Infinite graft survival in these recipients appears to represent a true immunological deficit since passive transfer of cells and sera from B rats with long-term surviving grafts failed to influence survival of test heart grafts in unmodified syngeneic recipients. Additionally, thymocytes, lymphoid cells, and TD cells from unsensitized rats or splenocytes from sensitized rats restored the capacity of the B recipient to reject then-grafts acutely. Thus, operative manipulations required to obtain profound depletion of T cells not only may result in prolonged cardiac graft survival but may also cause significant depletion of certain B cells. The less extensive ablative procedures of adult thymectomy or TD drainage only decrease T cells in selected compartments in rats; however, distribution of the effected T cells differ from those previously reported in mice undergoing similar procedures.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Anti-B cell, anti-T cell, and antiperipheral blood lymphocyte antibodies were investigated in the sera from 115 cadaveric kidney graft recipients pre- and post-transplantation. These antibodies were characterized: optimal temperature for cytotoxicity (4 C or 22 C), immunoglobulin class (IgG or IgM), and reactivity after platelet absorption, and thereafter defined according to their influence on the graft survival. Patients with IgM anti-B cell antibodies, reacting mostly at 4 C, the activity of which could not be removed by platelet absorption, have a prognosis of the graft as good as those with no antibody, i.e., the graft function (serum creatinine and severity of rejection) at 3 years was comparable between those two groups. However, when the anti-B cell antibodies unabsorbable on platelets are of IgG class and detected at 4 C and 22 C, the graft outcome is poorer (P< 0.025 at 3 months). A similar prognosis is observed in patients with antiperipheral blood lymphocyte antibodies of IgG or IgM class, absorbable or not on platelets (P< 0.05). Lymphocytotoxic antibodies of the IgG class are always associated with a poor graft outcome. On another hand, the cold anti-B cell antibodies of the IgM class are not associated with graft failure but no enhancing effect could be seen.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Various methods of reducing the immune response to allogeneic bone grafts, either by pretreating the graft or by immunosuppressing the recipient, were compared. Tibial grafts from B10.D2 mice, either untreated or pretreated in various ways, were transplanted into B10 recipients. The antibody response was followed and the extent of bone healing at 4 months was assessed. Pretreatment of the graft by X-irradiation, freezing, or by incubation in alloantisera (either anti-H-2 or anti-Ia) reduced or abolished the immunogenicity of the graft. Immunosuppression of the recipient with methotrexate or antilymphocyte serum (ALS) also greatly depressed the antibody response. But when graft healing was assessed, none of these treatments except ALS improved the delayed healing of the bone allografts. The reason for this failure was probably that X-irradiation, freezing, alloantiserum pretreatment, and methotrexate all interfered with bone healing directly, whereas ALS did not. We conclude that many methods will reduce the immune response to allogeneic bone, but that only ALS will improve the healing of the allogeneic bone. Furthermore, as a corollary to the observation that pretreatment with anti-Ia serum markedly reduced the immunogenicity of bone allografts, we conclude that much of the immunogenicity of bone allografts is attributable to a population of Ia-positive cells.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

Accelerated graft arteriosclerosis is a major cause of death in human heart transplantation. Despite many investigations, the pathogenesis of this disease remains undetermined and its control inadequate. In this study using a rat heart transplant model and cyclosporin A, a new immunosuppressant, acute rejection was prevented but arteriosclerotic-like vessel disease still developed consistently as early as 20 days postoperatively. The combination of cyclosporin A and dipyridamole prevented the development of this vessel disease in transplanted hearts at 20 and 50 days postoperatively. Sulfinpyrazone and cyclosporin A reduced but did not prevent the disease. These findings suggest that immunologically induced graft arteriosclerosis can be prevented in transplanted rat hearts by the combination of cyclosporin A and dipyridamole.

ISSN:0041-1337    

出版商:OVID    

年代:1981

数据来源: OVID