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【文摘发布】脑死亡来源的供体器官在肝移植后
Author:Weiss S, Kotsch K, Francuski M, Reutzel-Selke A, Mantouvalou L, Klemz R, Kuecuek O, Jonas S, Wesslau C, Ulrich F, Pascher A, Volk HD, Tullius SG, Neuhaus P, Pratschke J.
Source:Am J Transplant. 2007 Apr 8
IF:6.002(2005)
The majority of transplants are derived from donors who suffered from brain injury. There is evidence that brain death causes inflammatory changes in the donor. To define the impact of brain death, we evaluated the gene expression of cytokines in human brain dead and ideal living donors and compared these data to organ function following transplantation. Hepatic tissues from brain dead (n = 32) and living donors (n = 26) were collected at the time of donor laparotomy. Additional biopsies were performed before organ preservation, at the time of transplantation and one hour after reperfusion. Cytokines were assessed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and cytometric bead array. Additionally, immunohistological analysis of tissue specimens was performed. Inflammatory cytokines including IL-6, IL-10, TNF-alpha, TGF-beta and MIP-1alpha were significantly higher in brain dead donors immediately after laparotomy compared to living donors. Cellular infiltrates significantly increased in parallel to the soluble cytokines IL-6 and IL-10. Enhanced immune activation in brain dead donors was reflected by a deteriorated I/R injury proven by elevated alanin-amino-transferase (ALT), aspartat-amino-transferase (AST) and bilirubin levels, increased rates of acute rejection and primary nonfunction. Based on our clinical data, we demonstrate that brain death and the events that precede it are associated with a significant upregulation of inflammatory cytokines and lead to a worse ischemia/reperfusion injury after transplantation. 认领一个
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48小时不能交稿 请自由认领哦 大多数的器官移植物是来源于脑损伤的供者。有证据发现脑死亡会导致供者体内的炎性改变。为了确认脑死亡的影响，我们评价了人类脑死亡和理想的活体供者之间的细胞因子的基因表达，并将这些数据和移植后的器官功能做比较。从脑死亡来源的肝脏组织（32例）和活体供者的肝脏组织（26例）在供体开腹的时候采集。另外在器官保存前、移植时和再灌注后一小时分别再取标本。细胞因子用RT-PCR和细胞记数株排列评估。另外，还进行标本的免疫组化分析。和活体供者相比较，IL-6, IL-10, TNF-alpha, TGF-beta 和 MIP-1alpha等炎性细胞因子浓度在脑死亡的供者标本中显著增加。细胞灌注显著增加，和细胞因子IL-6、IL-10并列上升。恶化的缺血再灌注损伤反应了脑死亡供者增强的免疫激活， 该缺血再灌注损伤被脑死亡供者组增加的ALT、AST、胆红素水平、增加的急性排斥率和原发性肝脏无功能所证实。根据我们的临床资料，我们证明脑死亡或者经历过脑死亡的供者会伴随炎症因子的显著上调，从而导致移植后更严重的缺血再灌注损伤。 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-02-17 05:11
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