犬同種肺移植における FK-506 の免疫抑制効果 : 病理組織学的検討を中心に

Abstract

The Immunosuppressive effects of FK-506 were studied histologically in allotransplanted canine lungs. FK-506 was administered daily in a dose of 0.15mg/kg after left lung allotransplantation. Nine dogs underwent open lung biopsy on the 7th postoperative day (p.o.d.). Mild mononuclear cell infiltrations around small vessels (MNC cuffings), which suggested an early phase of rejection, were observed in 2 dogs. Two dogs were sacrificed on the 14th and 2 on the 21st p.o.d. MNC cuffings were observed in the lung of one dog and in the bronchial submucosa of 2 dogs. Six dogs were sacrificed on the 28th p.o.d. MNC cuffings were observed in the lungs of 3 dogs and in the bronchial submucosa of 5 dogs. The MNC cuffings were of nearly the same extent in the lung and in the bronchial submucosa of most of the dogs. Alveolar structures were well in all the dogs and the bronchial epithelium in all except 2 of the dogs sacrificed on the 28th p.o.d. preserved. Arterial blood gas was examined before and 20 min. after right hilar ligation in 3 dogs on the 28th p.o.d. The PaO_2 (228mmHg, 312mmHg, 217mmHg at FiO_2 : 0.5,tidal volume : 20ml/kg, respiratory rate : 20/min) and PaCO_2 after rt. hilar ligation indicated that the transplanted lung was functioning well in these dogs. The present study suggests that FK-506 could be a potent immunosuppressive agent in lung transplanation. As 4 of the 14 dogs used in this experiment died from severe diarrhea caused by FK-506,further studies are needed to determine the suitable dose and route of administration of FK-506.