人类肝移植中的肝引流淋巴结:异体免疫和耐受的意义

IF 1.6 4区 医学 Q4 IMMUNOLOGY
Mohamed I. Mohamed , Mattias Embretsen , Justin H. Nguyen
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引用次数: 0

摘要

背景:肝引流淋巴结(HDLN)与同种异体免疫和耐受有关。与实验研究相反,由于缺乏相关的临床组织,HDLN 在人类肝移植(LT)中的作用尚不清楚:方法:在肝移植过程中,原发性肝切除术在肝门附近切除肝门。方法:肝移植过程中,在原肝切除术中解剖肝门附近,在再灌注(再灌注前)前提取该区域的高密度脂蛋白。用受体门静脉血液进行完全再灌注后,肝动脉血流入异体移植物。随着受体肝总动脉的完全活动,其高密度脂蛋白网被移除并提交病理检查(再灌注后):结果:在2021年1月1日至2022年7月9日期间进行的37例LT手术中,20例在再灌注前和再灌注后均有HDLN存档(A组);11例仅有再灌注后的HDLN存档(B组);6例无HDLN存档(C组)。移除和存档 HDLN 不会增加手术时间或输血需求。A 组、B 组和 C 组的平均(标清)温暖缺血时间分别为 25.2 (2.0)、25.3 (3.2) 和 28.3 (6.2) 分钟(P > .05);手术时间分别为 3.9 (0.7)、6.9 (7.8) 和 7.9 (7. 1) 小时(A 组 vs. B 组)。1)小时(A vs C,P = .017;C vs B,P > .05);输注包装红细胞的单位分别为 8.0 (3.8)、11.1 (10.3) 和 12.2 (7.6)(P > .05):我们描述了一种在人体正位LT过程中在手术区域内获得的HDLN的临床存档方法。获得相关的 HDLNs 对于研究可能对异体移植物同种免疫和耐受性很重要的原发性免疫反应至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatic draining lymph nodes in human liver transplant: Implications in alloimmunity and tolerance

Background

Hepatic draining lymph nodes (HDLN) are implicated in allograft alloimmunity and tolerance. In contrast to experimental work, the role of HDLNs in human liver transplant (LT) is unknown due to lack of relevant clinical tissue.

Methods

During LT, the porta hepatis was dissected near the liver hilum during native hepatectomy. The HDLN in this region was taken prior to reperfusion (prereperfusion). Following complete reperfusion with recipient portal venous blood, hepatic arterial inflow into the allograft was established. As the recipient's common hepatic artery was fully mobilized, its HDLNs were removed and submitted to pathology (postreperfusion).

Results

Of 37 LTs performed between January 1, 2021, and July 9, 2022, 20 had both pre- and postreperfusion HDLNs archived (Group A); 11 had only postreperfusion HDLNs archived (Group B), and 6 had no archived HDLNs (Group C). Removing and archiving HDLNs did not increase operative times or transfusion requirements. For groups A, B, and C, mean (SD) warm ischemic times were 25.2 (2.0), 25.3 (3.2), and 28.3 (6.2) minutes, respectively (P > .05); operating times were 3.9 (0.7), 6.9 (7.8), and 7.9 (7.1) hours, respectively (A vs C, P = .017; C vs B, P > .05); and units of transfused packed red blood cells were 8.0 (3.8), 11.1 (10.3), and 12.2 (7.6), respectively (P > .05).

Conclusion

We describe an approach for clinical archiving of HDLNs obtained within the operative field during orthotopic LT in humans. Availability of relevant HDLNs is essential for investigations of primary immune responses potentially important in allograft alloimmunity and tolerance.
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来源期刊
Transplant immunology
Transplant immunology 医学-免疫学
CiteScore
2.10
自引率
13.30%
发文量
198
审稿时长
48 days
期刊介绍: Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.
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