Objective To review the research progress of Toll-like receptors （TLRs） signaling and its effects in organ transplantation. Methods The structural and functional features of TLRs and their ligands were summarized，the literatures in recent years about the research progress of TLRs signaling in animal experiment and clinical organ transplantation were reviewed. Results TRLs played an important role in the organ transplantation，the activation of TLRs could activate the specific immune system，and contribute to ischemic reperfusion injury，acute and chronic allograft rejections，and induce the immune tolerance. Early treatment intervention could reduce the activation of TRLs through ischemic reperfusion injury in the organ transplantation，and improve the allograft survival. The efficient immunosuppressive drugs which aimed at the related immunosuppressive target in immune and its signal transduction pathway could reduce ischemic reperfusion injury in the organ transplantation and immune rejection. Conclusions TRLs signaling plays an important role in ischemic reperfusion injury，immune rejection，and immune regulation.
【Abstract】ObjectiveTo compare the effects of self-designed KYL solution on rat liver preservation with UW solution. Methods Using non-circulated isolated perfused rat liver,SD rat livers were randomly preserved for 0、4、8、16、24 and 48 hours with self-designed KYL solution or UW solution. The effects were assessed by measuring the bile production, the contents of AST， ALT，LDH，free radical（ MDA） and SOD in KrebsHenseleit’s perfusate and the content of intracellar calaium of the rat hepatocytes, and by observing the morphological changes in liver. At the same time, the normal saline was used to preserve the rats liver as negative comparison to know if KYL solution and UW solution can prevent the ischemiareperfusion injury in rat liver transplantation.Results At different periods within 16 hours of preservation,the bile production of the rat livers which were preserved by KYL solution were more than those were preserved by UW solution （P＜0.01）, JP2The contents of AST， ALT and LDH in Krebs-Henseleit’s perfusate were near in UW solution’s. The content of intracellar calaium of the rat hepatocytes which were preserved by KYL solution were less than those were preserved by UW solution （P＜0.01）. In KYL group, the content of MDA was lower than that UW group, the content of SOD was higher than that UW group at 24 and 48 h(P＜0.01). Morphological changes in both groups were almost same. All variables of both groups were better than the rat livers preserved by the normal saline. It was proved that both KYL solution and UW solution could protect the rat livers. Conclusion The study indicated that the effects of self-designed KYL solution on rat liver preservation are similar to that of UW solution. The bile production after reperfusion and the content of intracellar calaium of the rat hepatocytes in KYL group are better than those in UW group .The effect of prevention of rat hepatocellular oedema by self-designed KYL solution are worse than that of UW solution.
Objective To explore the effect of cytotoxic T lymphocyte-associated antigen 4 (CTLA4-Ig) fusion protein on the function of orthotopic liver allograft. Methods Orthotopic liver allograft models of rhesus monkeys were established in this study. The survival time, liver function and morphologic changes of graft were observed, respectively. The levels of IL-2 and IL-10 were detected by ELISA. Apoptosis was monitored by TUNEL.Results The average survival of control group was 6.57 d, while the average survival of CTLA4-Ig group was 14.92 d, which was statistically prolonged (Plt;0.05). Serum ALT level was highly increased, and Alb level decreased obviously in control group. While the levels of ALT and Alb kept in normal in CTLA4-Ig group. After day 3-7, the expressions of IL-2 were highly expressed in control group, while the expressions of IL-10 in CTLA4-Ig group were higher than those of control group. The severity of rejection reaction after day 3 was weaker in CTLA4-Ig group than that of control group by histological assessment. The apoptosis index after day 3 in the liver cells was highly increased in control group as compared with the CTLA4-Ig group. Conclusions CTLA4-Ig fusion protein therapy can induce immunotolerance and prolong the survival of recipients. The increasing of cytokines IL-2 or the decreasing of cytokines IL-10 may be one of the laboratory indexes in monitoring immunotolerance of transplantation.
目的总结1例亲体部分肝移植的临床体会。方法受者为5.5岁男童，诊断为先天性肝脏巨大肿瘤; 供者为患儿母亲，34岁; 切取供者肝脏的左叶并原位移植给患儿。术后给予抗感染、抗免疫排斥反应等支持治疗。结果患儿手术历时9 h，失血250 ml; 供者手术历时3 h，失血450 ml。术后供、受者均健康存活，肝功能正常。结论活体肝部分移植技术是可行的，良好的手术及术后处理是确保肝移植手术成功的关键。
目的探讨肝肾联合移植的手术技术及临床治疗经验。方法对1例原发性弥漫性肝癌、肝硬变合并肾病综合征、慢性肾功能衰竭患者施行一期肝肾联合移植术，肝移植采用改良背驮式肝移植技术，肾移植采用常规方法。术前、术后行全身辅助性化疗。结果移植肝肾发挥功能，无手术并发症发生，术后3个月无肿瘤复发征象及远处转移，AFP下降到25 μg/L以下。结论对常规手术无法切除且无远处转移的肝癌合并肾功能衰竭者行肝肾联合移植，可以取得较好的临床治疗效果。