Abstract: Objective To study the antiacute rejection effect of Pachymic acid (PA) in heart transplantation rats, in order to select a new antirejection medicine with low side effect from traditional Chinese medicine. Methods We established the model by transplanting Wistar rats (32,donor) heart allografts into the abdomen of SD rats (32,receptor). The homologous hearttransplanted rats were then randomly divided into 4 groups with 16 rats in each group. Olive oil solution with PA 1 mg/(kg·d), PA 10 mg/(kg·d), Cyclosporine (CsA) 5 mg/(kg·d) and olive oil solution 0.5 ml/(kg·d) were respectively given intragastrically to lowdosage PA group, highdosage PA group, CsA group and the control group till the end of observation. Survival time of heart allografts, heart beating and the histological changes of allografts were examined and serum level of interleukin2 (IL-2) and interferon-γ (IFN-γ) were determined by enzymelinked immunosorbent assay (ELISA). Results Survival time in the highdosage PA group, the lowdosage PA group and the CsA group were 24.90±0.99 d, 15.50±1.60 d and 26.80±0.88 d respectively, which is much better than the control group (6.10±1.10 d, q=22.363, P=0.000; q=44.793, P=0.000; q=49.272,P=0.000). IL-2 serum level in the highdosage PA group, the lowdosage PA group and the CsA group were all lower than that in the control group (q=14.483, P=0.000; q=3.705, P=0.000; =21.418,P=0.000), whileIL-2 serum level in the highdosage group was lower than that in the lowdosage group (q=10.778,P=0.000). Similarly, IFN-γ serum level in the first three groups were all lower than that in the control group (q=16.508,P=0000; q=4.281, P=0.000;q=19.621, P=0.000) and IFNγ serum level in the highdosage group was also lower than that in the lowdosage group (q=14.975, P=0.000). Pathological examination 7 days after the surgery showed that pathologic lesion was much more relieved in the two PA groups and the CsA group than the control group. Conclusion Acute rejection of heart transplantation can be effectively suppressed by PA.
Abstract: Objective To summarize the surgical outcomes and clinical experience of surgical disease for patients having undergone orthotopic heart transplantation. Methods Five cardiac transplant recipients requiring surgical management due to other surgical diseases including acute cholecystitis in 2 patients, acute appendicitis, bilateral mammary hypertrophy and lung tumor in 1 patients, respectively. The mean age of the entire group at the time of reoperation was 44. 6 years (14-60 years) and the average time of operative procedures after transplant was 16. 4 months (4-37 months). Four patients were treated with t riple immunosuppression, including cyclosporine A (CsA ) or tacroimus, mycophenolate mofetil and corticosteroids, respect ively. One patient received double-therapy of CsA and mycophenolate mofetil withearly withdrawal of corticosteroids. All the acute cholecystitis and appendicitis patients underwent open cholecystectomy and appendectomy emergently. Reduction mammaplasty was performed on the bilateral mammary hypert rophy patients. For the lung tumor patient, right upper lobectomy and nodes excision were undertaken radically after the sample proved to be malignancy by the thoracoscopy. Closely surveillance at concentration of CsA or FK506 was performed continueously in o rder to adjust the effect ive blood concentration in a steady way by which acute rejection can be avoided. The pathways which pathogen organisms invading the human body were controlled strictly as well as intension on ant i-infection treatment during perioperative period. Results Four patients discharged to home within 2 weeks. Only one patient needed further treatment in Digestive Department after emergent cholecystectomy due to gastric retention. And shewas discharged after 66 days. No acute reject ions or operative complications such as severe infection or bleeding were found during the perioperative period. The average length of stay was 21. 3 days (8-66 days). During the fo llow -up from 1month to 13months, there was no relapse or allograft disfunction performed on any patients. All of them enjoy quality lives. Conclusions More attention should be paid to regular follow -up after transplantation, by which the emergent surgical diseases can be diagnosed and treated earlier and more effectively. Cardiac transplant recipients who subsequently require surgical intervention do quite well overall. Most of them can obtain excellent surgical outcomes.
Abstract: Cardiac transplantation is an effective therapeutic method for terminalstage heart diseases. The immunosuppressive treatment based on calcineurin inhibitors (CsA and FK506) is most commonly used, monoclonal antibodies are also used in some recipients as induction therapy before and/or after transplantation. Some new immunosuppressive drugs, such as Rapamycin and Everolimus, can not only inhibit the acute transplant rejection but also prevent cardiac vasculopathy. The application of some relatively nontraumatic tests, such as immunological indexes, cardiac markers and other serological parameters, are helpful for diagnosis and preventing postcardiac transplant rejection at early stage and improving the result of cardiac transplantation.
Objective To establ ish the modified model of cervical heterotopic cardiac transplantation in rats for investigation of cardiac chronic rejection. Methods Forty healthy male Wistar rats, aged 10 weeks, weighing 250-300 g, were appl ied as the donor group, and forty healthy male SD rats, aged 10 weeks, weighing 300-350 g, served as the recipient group. The donors’ pulmonary artery was anastomosed to the reci pients’ right external jugular vein by non-suture cuff technique while the donors’ innominate artery was anastomosed to the recipients’ right common carotid artery by suture microvascular anastomosis. All recipients received cyclosporin to prevent acute allograft rejection. Results Forty consecutive successful transplantations were performed. Neither anastomosis leakage nor vessel obstruction occurred. The total operation time was 40-50 minutes. The time of cuff vascular anastomosis was 2-3 minutes and that of microvascular anastomosis was 9-12 minutes. All recipients survived for more than 30 days and all allografts were examined at 30 days after the transplantation. Pathological manifestations of allograft vessels were chronic rejection. Conclusion This modified model of cervical heterotopic cardiac transplantation is simple, practical and highly reproducible and is appl icable for investigation of chronic rejection in various organ transplantation studies.