Canine Limb Allotransplantation the First Veterinary Clinical Attempt

本研究探討新型式免疫抑制劑組合應用於犬肢體異體移植之效果。肢體之接受者為七歲之雌犬，其右前肢因不明原因於肘下截肢已有三年，捐贈者則為兩歲之雄犬，兩者之體型及血液均互相配合。移植後之肢體以合併使用之prednisolone，tacrolimus，以及leflunomide來控制排斥反應，移植初期之組織血液灌流良好，肢體正常存活並長出體毛。移植後40日，移植物出現初期輕微之排斥反應，經增加免疫抑制劑量後仍持續惡化，直到術後60日完全排斥，肢體經手術移除為止。組織切片顯示，血管排斥為移植失敗之主要原因，聚合酶鍊反應則顯示在移植後任何時期，接受者體內均無捐贈者含Y染色體之細胞以微細胞交移之型式存在。本臨床研究之結論為，肢體之體移植在技術上已經可行，唯排斥控制在成效及副作用方面仍然未盡理想，需要進一步發展更為有效而且長期毒性較低之免疫控制計畫。

關鍵字

犬；肢體移植；微細胞交移；排斥

並列摘要

To study the feasibility of canine limb allotransplantation under novel combination of immunosuppressive agents, the right forelimb of a 2-year-old male Shiba dog was transplanted to a 7-year-old female terrier recipient suffered from an amputation 3 years earlier. The animals were compatible in body size and blood type. Rejection was controlled by administering a combination of prednisolone, tacrolimus and leflunomide. The limb allograft survived the early postoperative phase with good perfusion and hair re-growth. Very early signs of rejection were noted on day 40, which progressed despite increasing the dose of the immunosuppressive agents. The graft was totally rejected and amputated on day 60. Histologically, vascular rejection was identified as the prime reason leading to graft failure. No microchimerism of Y-chromosome-positive cells were detected by PCR at any time during the period. In conclusion, canine limb allotransplantation is technically feasible yet rejection control is challenging. Further investigation into an effective and nontoxic immunosuppressive protocol is warranted.

並列關鍵字

Dog ； Limb transplantation ； Microchimerism ； Rejection

國際替代計量

Canine Limb Allotransplantation the First Veterinary Clinical Attempt

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