BACKGROUND: Arterial allografts are used as vascular conduits in the treatment of prosthetic graft infection. Immunosuppression decreases their rupture risk rate. However, immunosuppression can be unprofitable in florid infection. Previously, we confirmed inhibition of cell-mediated destruction of rat aortic grafts by delayed use of tacrolimus. In this work, we studied the influence of this protocol on the antibody-mediated rejection. MATERIAL AND METHODS: Flow cytometry was used for the retrospective analysis of day 0, 14, and 30 sera obtained from Lewis rat recipients of isogeneic fresh infrarenal aortic grafts (group A) or Brown-Norway rat aortic grafts (group B,C,D) for the presence of donor-specific anti-MHC class I and II antibodies. Tacrolimus in daily dose of 0.2 mg/kg was administered from day 1 to day 30 (group C) or from day 7 to day 30 (group D). RESULTS: Inhibition of fluorescence-labeled anti-BN MHC class I and MHC class II antibodies binding to BN-splenocytes was observed only by day 14 and day 30 sera of allogeneic non-immunosuppressed Lewis rats (group B). The day 30 sera significantly decreased anti-MHC I (42±3%) and anti-MHC II antibody binding (56±3%) compared to day 0 (76±9%, p=0.005 and 79±5%, p=0.003, respectively). Deposition of immunoglobulins G into the tunica media was observed only in non-immunosuppressed aortic allografts on day 30. CONCLUSIONS: Fresh aortic allografts induce donor-specific anti-MHC class I and anti-MHC class II antibody production. Delayed administration of tacrolimus completely suppressed antibody production and antibody-mediated destruction of aortic allografts.
- MeSH
- aorta transplantace MeSH
- B-lymfocyty imunologie MeSH
- CD8-pozitivní T-lymfocyty imunologie MeSH
- homologní transplantace MeSH
- imunosupresiva farmakologie MeSH
- isoprotilátky imunologie MeSH
- krysa rodu rattus MeSH
- MHC antigeny I. třídy imunologie MeSH
- MHC antigeny II. třídy imunologie MeSH
- potkani inbrední BN MeSH
- potkani inbrední LEW MeSH
- rejekce štěpu farmakoterapie imunologie MeSH
- slezina cytologie imunologie MeSH
- takrolimus farmakologie MeSH
- transplantace cév metody MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES AND DESIGN: We investigated whether immunosuppression was necessary for transplanted allogeneic veins to adapt to arterialisation. We used a transplant rat model with or without immunosuppression. MATERIAL AND METHODS: Iliolumbar veins from Lewis (LEW) or Brown-Norway (BN) rats were transplanted into the abdominal aorta of isogeneic (LEW to LEW; group A) or allogeneic (BN to LEW; groups B and C) rats. Group C had daily intramuscular injections of 0.2mgkg(-1) FK506. Light microscope evaluations of grafts were performed at 30 days following transplantation. We determined the presence of endothelial cells, the intensity of intimal proliferation and the degree of infiltration by Lewis major histocompatibility complex (MHC) class II positive, CD4-positive and CD8-positive cells into the adventitia. RESULTS: Groups A and C displayed similar results in intimal thickness (12.7+/-7.0microm vs. 15.0+/-8.4 mum, respectively) and degree of adventitial infiltration by MHC class II positive (16.6+/-7.5 vs. 14.6+/-6.2, respectively), CD8-positive (0.8+/-1.7 vs. 1.8+/-2.6, respectively) and CD4-positive (12.5+/-7.7 vs. 5.8+/-4.6, respectively) cells. In contrast, allogeneic rats without immunosuppression (group B) showed infiltration of host immunocompetent cells and destruction of the venous wall with no histological signs of arterialisation. CONCLUSION: Immunosuppressive therapy is necessary for venous allograft adaptation to arterialisation in rats.
- MeSH
- aorta abdominalis chirurgie MeSH
- časové faktory MeSH
- CD4-pozitivní T-lymfocyty účinky léků imunologie MeSH
- CD8-pozitivní T-lymfocyty účinky léků imunologie MeSH
- endoteliální buňky účinky léků patologie MeSH
- fyziologická neovaskularizace účinky léků MeSH
- homologní transplantace MeSH
- imunosupresiva aplikace a dávkování farmakologie MeSH
- injekce intramuskulární MeSH
- krysa rodu rattus MeSH
- modely u zvířat MeSH
- pohyb buněk účinky léků MeSH
- potkani inbrední BN MeSH
- potkani inbrední LEW MeSH
- přežívání štěpu účinky léků MeSH
- proliferace buněk účinky léků MeSH
- rejekce štěpu imunologie patologie prevence a kontrola MeSH
- svaly hladké cévní účinky léků patologie MeSH
- takrolimus aplikace a dávkování farmakologie MeSH
- vény účinky léků imunologie patologie transplantace MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- aneurysma břišní aorty chirurgie MeSH
- aorta abdominalis chirurgie transplantace MeSH
- arteria iliaca chirurgie transplantace MeSH
- arteriální okluzní nemoci chirurgie komplikace mortalita MeSH
- arterie imunologie transplantace MeSH
- ateroskleróza chirurgie MeSH
- cévy imunologie transplantace MeSH
- dárci tkání klasifikace MeSH
- dolní končetina chirurgie krevní zásobení MeSH
- dospělí MeSH
- financování organizované MeSH
- homologní transplantace imunologie metody využití MeSH
- imunosupresivní léčba metody MeSH
- infekce spojené s protézou farmakoterapie imunologie MeSH
- kryoprezervace MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- morbidita MeSH
- mykózy MeSH
- pacienti klasifikace MeSH
- pooperační komplikace farmakoterapie imunologie mortalita MeSH
- přežití MeSH
- průchodnost cév MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- statistika jako téma MeSH
- vény imunologie transplantace MeSH
- výkony cévní chirurgie MeSH
- výsledek terapie MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- záchrana končetiny MeSH
- zákroky plastické chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
The concomitant presence of a thoracic aortic aneurysm and an abdominal aortic aneurysm in patients considered for renal transplantation is extremely rare. To our knowledge, this is the first case report of the successful treatment of multilevel aortic aneurysms together with renal transplantation. The treatment modalities in renal transplant patients with concomitant aortic aneurysms are discussed.
OBJECTIVES: An increasing number of aortoiliac lesions and abdominal aortic aneurysms occur in renal failure patients waiting for renal transplantation. The aim of our study was to assess long term results of simultaneous renal transplantation and surgical repair of aortoiliac lesions with arterial allografts. DESIGN: A retrospective observational study. PATIENTS AND METHODS: From October 1997 to June 2007, we performed simultaneous aortoiliac reconstructions using fresh arterial allografts and kidney transplantation in 14 patients with chronic renal failure (men 9, women 5, mean age 53 years). The indication for vascular reconstruction was an asymptomatic abdominal aneurysm in 6 patients or aortoiliac stenosis/occlusion in 8 patients. The median follow up period for the cohort was 55.5 months (range from 1 to 116 months). RESULTS: Three patients died during the follow up period. In none of them there was an allograft (neither arterial nor renal) related death. No signs of arterial grafts infection or aneurysmal formation and no need for secondary intervention (angioplasty and/or thrombolysis) of any arterial reconstruction was observed during the follow up period in any patient. The renal grafts failed in three patients. CONCLUSIONS: Our experience suggests that it is possible and safe to use arterial allografts in the treatment of arterial occlusive disease or abdominal aortic aneurysm simultaneously with renal transplantation.
- MeSH
- aneurysma břišní aorty epidemiologie chirurgie MeSH
- arterie transplantace MeSH
- chronické selhání ledvin epidemiologie chirurgie MeSH
- dehiscence operační rány chirurgie MeSH
- dospělí MeSH
- financování organizované MeSH
- homologní transplantace MeSH
- imunosupresiva terapeutické užití MeSH
- intermitentní klaudikace chirurgie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- rejekce štěpu epidemiologie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- transplantace ledvin MeSH
- výkony cévní chirurgie metody MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
Arterial allografts are used now-a-days as a modality in the treatment of vascular prosthesis infections. Prolonged administration of immunosuppressive drugs seemed to be essential for long-time patency rates of alloarterial vascular reconstructions. Nevertheless, the use of immunosuppressives if there exist an acute infection is controversial. The experimental work described herein studied effects of a delayed low-dose FK 506 administration on the development of acute rejection changes 30 days after aortal transplantation in rats. The response of the recipient's immune system to aortal wall antigens of the donor in the field of no immunosuppression resulted in an intimal proliferation and its infiltration by immunocompetent cells of the recipient, necrosis of medial smooth muscle cells, including deposition of immunoglobulins, and a massive adventitial infiltration of CD4 and CD8 positive cells. On the other hand, all the principal histological signs of rejection listed above were suppressed by FK 506 administration, no matter whether the immunosuppressive was administered on day 0 or day 7 after the transplantation.
- MeSH
- aorta patologie transplantace MeSH
- CD4-pozitivní T-lymfocyty cytologie MeSH
- CD8-pozitivní T-lymfocyty cytologie MeSH
- financování organizované MeSH
- imunohistochemie MeSH
- imunosupresiva aplikace a dávkování MeSH
- krysa rodu rattus MeSH
- potkani inbrední BN MeSH
- potkani inbrední LEW MeSH
- rejekce štěpu farmakoterapie patologie MeSH
- takrolimus aplikace a dávkování MeSH
- tunica intima patologie účinky léků MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
OBJECTIVES: To assess the outcome of cold-stored venous allografts in critically ischemic limbs in patients with no ipsilateral autogenous greater saphenous vein. DESIGN: A non-randomised, retrospective, single-center study. METHODS: From September 2000 to June 2006, 46 cold-stored venous allografts obtained during multiorgan harvest were implanted into 44 critically ischaemic limbs of 43 patients. The indication for reconstructions was rest pain (24%) or tissue lost (76%). Sixty-seven percent of procedures were performed as secondary reconstructions, and 61% of veins were anastomosed to tibial or pedal arteries. Thirty-seven percent of patients received prednisone, and 46% tacrolimus as postoperative immunosuppressive therapy. Mean patient follow-up period was 13.3 months (range 1 week to 60 months). RESULTS: The secondary patency rate for the cohort was 83+/-5.6% at 1 month, 64+/-8.2% at 6 months, 57+/-10.0% at 12 months and 46+/-10.7% at 24 months. Limb salvage rate was 96+/-3.1% at 1 month, 78+/-6.9% at 6 months, 71+/-8.1% at 12 months and 50+/-11.8% at 24 months. CONCLUSION: Cold-stored venous allografts are an alternative conduit for limb salvage procedures when ipsilateral autogenous vein is unavailable.
- MeSH
- anastomóza chirurgická MeSH
- cévní protézy MeSH
- cévy - implantace protéz MeSH
- dolní končetina chirurgie krevní zásobení MeSH
- financování organizované MeSH
- homologní transplantace MeSH
- ischemie chirurgie MeSH
- kryoprezervace MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- průchodnost cév MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- záchrana končetiny statistika a číselné údaje MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
