Research in Experimental Medicine

, Volume 178, Issue 2, pp 79–101 | Cite as

Die allogene Lebertransplantation

I. Morphologische und funktionelle Veränderungen in experimentellen Untersuchungen beim Schwein
  • H. Bockhorn
Review Article

Zusammenfassung

MHC-inkompatible allogene Lebertransplantate werden von Schweinen weniger aggressiv abgestoßen als allogene Haut- oder Nierentransplantate und können daher ohne Immunsuppression akzeptiert werden. Trotz dieser immunologischen Besonderheit der Leber sind morphologisch und funktionell Abstoßungsreaktionen zu erkennen, deren Stärke von der Differenz der Histokompatibilität der Spender-Empfängerpaare abhängt. Die immunologische Auseinandersetzung des Empfängers mit dem allogenen Transplantat führt bei Langzeitüberlebern zu einer zunehmenden Fibrose, die in eine Lebercirrhose übergehen kann und als Ergebnis einer chronischen Abstoßungsreaktion zu deuten ist. Morphologisch und enzymatisch fällt die Cholestase auf, die vorwiegend eine komplexe Schädigung der Leber durch Perfusion, Infektion und Transplantatreaktion darstellt.

Schlüsselwörter

Orthotope allogene Lebertransplantation Abstoßungsreaktion Major Histocompatibility Complex 

The allogeneic liver transplantation

I. Morphological and Functional Patterns in Pig Liver Allografts

Summary

Pigs usually reject MHC incompatible liver allografts less aggressively than skin or kidney allografts. Orthotopic liver allografts can survive undefinitely without any immunsuppression. The liver is considered to be an immunologically preveliged organ. Despite this phenomenon, morphological changes and deranged liver function due to rejection reaction are regulary seen; their intensity depends on the histocompatibility antigen disparity between donor and recipient. In long-term survivors the continous exposure of the recipient's immune system to the liver allograft results in an increasing fibrosis which can turn into liver cirrhosis being considered as the result of chronic rejection. The cholestasis represents a remarkable feature, which is mainly due to perfusion, infection and immunological reaction.

Key words

Orthotopic liver allograft Rejection reaction Major Histocompatibility Complex 

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Literatur

  1. 1.
    Alican F, Hardy JD (1967) J Surg Res 7:368–375Google Scholar
  2. 2.
    Amos DB, Junis EJ (1971) Cell Immunol 2:517–521PubMedGoogle Scholar
  3. 3.
    Berman MC, Harrison GG, Bull AB, Kench JE (1970) Nature 225:653–655PubMedGoogle Scholar
  4. 4.
    Binns RM (1967) Nature 214:179–181PubMedGoogle Scholar
  5. 5.
    Bockhorn H, Grotelüschen B, Tidow G, Schmidt E, Lesch P, Taeger K, Ziegler H, Pfeiffer A, Seidler D, Siegismund S, Lauchart W, Steinigeweg W, Pichlmayr R (1972) Langenbecks Arch Chir Forum [Suppl], pp 135–138Google Scholar
  6. 6.
    Bohle A, Hinrichsen K (1966) Klin Wochenschr 47:74–77Google Scholar
  7. 7.
    Bradley BA, Edwards JM, Dunn DC, Calne RY (1972) Nature New Biol 240:54–56PubMedGoogle Scholar
  8. 8.
    Calne RY, White HJO, Yoffa DE, Binns RM, Maginn RR, Herbertson BM, Millard PR, Molina VP, Davies DR (1967) Br Med J 4:645–647PubMedGoogle Scholar
  9. 9.
    Calne RY, Selis RA, Pena JR, Davies DR, Millard PR, Herbertson BM, Binns RM, Davies DAL (1969) Nature 223:472–476PubMedGoogle Scholar
  10. 10.
    Calne RY (1974) In: Lie TS, Gütgemann A (eds) Liver transplantation. Bonn: 1st Internat Symposion of Liver Transplantation (June 23.–25., 1972), pp 39–46Google Scholar
  11. 11.
    Calne RY, English TAH, Dunn DC, McMaster P, Wilkins D, Wilkins D, Herbertson BM (1976) Transplant Proc 8:27–30PubMedGoogle Scholar
  12. 12.
    Calne RY (1976) Br Med Bull 32:107–112PubMedGoogle Scholar
  13. 13.
    Calne RY, Williams R (1977) Br Med J 1:471–476PubMedGoogle Scholar
  14. 14.
    Chomette G, Garnier H, Clot JP, Pinnandeau Y, Auriol M, Brocheriou C (1969) Virchows Arch [Pathol Anat] 347:176–179Google Scholar
  15. 15.
    Corry RJ, Kelly SE (1977) Transplant Proc 9:945–947PubMedGoogle Scholar
  16. 16.
    Daloze P, Fourtanier G, Beaudouin M, Corman J, Smeesters C, Saric J (1977) Transplant Proc 9:309–312PubMedGoogle Scholar
  17. 17.
    Dausset J, Hors J (1972) Nature New Biol 238:150–152PubMedGoogle Scholar
  18. 18.
    De Bono DP (1972) Transplantation 14:438–439PubMedGoogle Scholar
  19. 19.
    Demant P (1973) Transplant Rev 15:162–200PubMedGoogle Scholar
  20. 20.
    Garnier H, Clot JP, Chomette G (1970) Surg Gynecol Obstet 130:105–111PubMedGoogle Scholar
  21. 21.
    Goodrich EO, Welch HF, Nelson JA, Becker TS, Welch CS (1956) Surgery 39:244–251PubMedGoogle Scholar
  22. 22.
    Gowans JL, McGregor DD, Cowen DM (1962) Nature 196:651–655PubMedGoogle Scholar
  23. 23.
    Groth CG, Portek KA, Otte JB, Daloze PM, Marchioro TL, Brettschneider L, Starzl TE (1968) Surgery 63:658–668PubMedGoogle Scholar
  24. 24.
    Guttmann RD, Linquist RR (1971) Transplant Proc 3:717–720PubMedGoogle Scholar
  25. 25.
    Harrison GG, Saunders SJ, Biebuyck JF (1969) Br J Anaesth 41:844–854PubMedGoogle Scholar
  26. 26.
    Hell E, Boeckl O, Gibitz JH, Zimmermann G (1972) Wien Klin Wochenschr 84:222–226PubMedGoogle Scholar
  27. 27.
    Herbertson BM (1973) In: Calne RY (ed) Immunological aspects of transplantation surgery. MTP Publishing, Lancaster, England, pp 4–38Google Scholar
  28. 28.
    Howanietz LF (1975) Wien Klin Wochenschr 87:[Suppl 44] 3–13Google Scholar
  29. 29.
    Hunt AC (1967) In: Read AF (ed) The liver. Butterworth, London, p 337Google Scholar
  30. 30.
    Jerusalem C, Jap PHK (1976) Handbuch Allg Pathol, VI/8. Springer, Berlin Heidelberg New YorkGoogle Scholar
  31. 31.
    Krause HP, Bockhorn H, Pichlmayr R (in Vorbereitung)Google Scholar
  32. 32.
    Mahnke PF, Cossel L, Schwarzer R, Otto U (1975) Zentralbl Allg Pathol 119:495–526PubMedGoogle Scholar
  33. 33.
    Millard PR, Herbertson BM, Calne RY (1971) Transplant Proc 3:505–508PubMedGoogle Scholar
  34. 34.
    Myburgh JA, Abrahams C, Mendelsohn D, Mieny CJ, Bergsohn J (1971) Transplant Proc 3:501–504PubMedGoogle Scholar
  35. 35.
    Myburgh JA, Smit JA (1975) Transplantation 19:64–71PubMedGoogle Scholar
  36. 36.
    Porter KA (1969) In: Starzl TE, Putman CW (eds) Experience in hepatic transplantation. Saunders, Philadelphia, pp 422–471Google Scholar
  37. 37.
    Ringe B (1975) Dissertation, Medizinische Hochschule HannoverGoogle Scholar
  38. 38.
    Seidler D, Trautwein G, Lauchart W, Bockhorn H (1974) Z Immunol Forsch 148:9–15Google Scholar
  39. 39.
    Simonsen M (1970) Transplant Rev 3:22–35Google Scholar
  40. 40.
    Sinclair RA (1972) Br Med J 3:15–17Google Scholar
  41. 41.
    Schaffner F, Popper H (1969) Lancet 2:355–356PubMedGoogle Scholar
  42. 42.
    Schalm SW, Terpstra JL, Popescu DT, Krom RAF, Jerusalem C (1975) Surgery 78:637–643PubMedGoogle Scholar
  43. 43.
    Schmidt E, Schmidt FW, Wildhirt E (1958) Klin Wochenschr 36:611–616PubMedGoogle Scholar
  44. 44.
    Schmidt E, Schmidt FW, Lesch P, Siegismund S, Bockhorn H, Pichlmayr R (1974) In: Lie TS, Gütgemann A (eds) Liver transplantation. Bonn: 1st Internat Symposion of Liver Transplantation (June 23.–25., 1972), pp 73–78Google Scholar
  45. 45.
    Starzl TE (1969) In: Starzl TE, Putman CW (eds) Experience in hepatic transplantation. Saunders, PhiladelphiaGoogle Scholar
  46. 46.
    Starzl TE (1971) In: Good RA, Fisher DW (eds) Immunology. Sinauer, Stanford, pp 195–208Google Scholar
  47. 47.
    Starzl TE, Porter KA, Putman CE, Schroeter GPJ, Halgrimson CG, Weil III. R, Hoelscher M, Reid HAS (1976) Surg Gynecol Obstet 142:487–505PubMedGoogle Scholar
  48. 48.
    Strom TB, Carpenter CB, Garovoy MR, Abbas AK, Corson JM, Bear RA, Soulilon JP (1975) Transplantation 20:368–380PubMedGoogle Scholar
  49. 49.
    Stuart FP, Torres E, Hester WJ, Dammin GJ, Moore FD (1967) Ann Surg 165:325–340PubMedGoogle Scholar
  50. 50.
    Terblanche J, Peacock JH, Bowes H, Davies R, Tierris EJ, Palmer DB, Hunt AC (1967) Br J Surg 54:231–233Google Scholar
  51. 51.
    Terblanche J, Peacock JH, Bowes J, Hobbs KEF (1968) J Surg Res 8:151–160PubMedGoogle Scholar
  52. 52.
    Themann H, Roessner A, Fasske E, Lie TS, Kolicock R, Bassewitz DB v (1974) In: Lie TS, Gütgemann A (eds) Liver transplantation. Bonn: June 23.–25., 1972), pp 297–298Google Scholar
  53. 53.
    Thomas J, Thomas F, Kaplan A (1977) Transplant Proc 9:85–89PubMedGoogle Scholar
  54. 54.
    Trentini JJ (1966) Ann NY Acad Sci 129:654–656Google Scholar
  55. 55.
    Vaiman M, Garnier H, Kunlin A, Hay JM, Parc R, Bacourt F, Fagniez PH, Villiers PA, Lecointre J, Bara MF, Nizza P (1972) Transplantation 14:541–542PubMedGoogle Scholar
  56. 56.
    Vaiman M (1973) Thesis, Université de Paris VIIGoogle Scholar
  57. 57.
    Vaiman M, Bacourt F, Villiers PA, Garnier H (1976) Transplantation 22:402–404PubMedGoogle Scholar
  58. 58.
    Viza D, Sugar JR, Binns RM (1970) Nature 227:949–950PubMedGoogle Scholar
  59. 59.
    Waldram R, Williams R, Calne RY (1975) Transplantation 19:382–387PubMedGoogle Scholar
  60. 60.
    Wallnöfer H, Schmidt E, Schmidt FW (1974) In: Synopsis der Leberkrankheiten. Thieme, StuttgartGoogle Scholar
  61. 61.
    White DJG, Bradley BD, Calne RY, Binns RM (1973) Transplant Proc 5:317–329PubMedGoogle Scholar
  62. 62.
    White DJG (pers Mitteilungen)Google Scholar
  63. 63.
    Wilson DB, Nowel PC (1971) J Exp Med 133:442–443PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1981

Authors and Affiliations

  • H. Bockhorn
    • 1
  1. 1.Chirurgische Klinik und PoliklinikEberhard-Karls-UniversitätTübingen 1Bundesrepublik Deutschland

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