心移植における拒絶反応 : 病理組織学的ならびに免疫組織化学的所見
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概要
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Histopathological and immunohistochemical findings of the rejection phenomenon in a case of heart transplantation at the Sapporo Medical College are presented. The case, 18-year-old male, who expired 82 days after cardiac transplantation developed a characteristic immunological response of the cardiac tissue, especially of the myocardium, as well as of the branches of coronary arteries. The immunological response of the cardiac tissue was characterized by disorganization of the capillary structure, basophilic swelling and proliferation of stellate or spindle-shaped cells in a reticular arrangement, proliferation and infiltration of lymphocytes, plasma cells, and basophilic mononuclears in the cellular network, and associated homogenization, fragmentation, appearance of Anitschkow type cells, or hyalinization myofibers in the myocardium. It was suggested from the immunohistochemical analysis that of an anti-cardiac myofiber antibody plays a pathogenic role in the occurrence of the characteristic lesions of myofibers involved in the rejection phenomenon in the myocardium. On the other hand, the lesions of the branches of coronary arteries were summarized as an endoarteritis obliterans characterized by intimal hyperplasia due to proliferation of basophilic cells with reticular arrangement, which was sometimes accompanied by degenerative and proliferative changes of the media and adventitia. It appears noteworthy that the obliterating endoarteritis was inevitably associated with secondary myomalacia of the tributary areas. Pathogenesis of the rejection phenomenon in heart transplantation was considered and discussed on the bases of the findings demonstrated in this case.
- 日本アレルギー学会の論文
- 1969-10-30
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