Anti-rejection effect of ethanol extract of Poria cocos wolf in rats after cardiac allograft implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A living fetus within the maternal uterus provides an example of allogene tolerance in mammals. Poria cocos Wolf is the main component of many Chinese medicinal combination drugs that have therapeutic effects on recurrent spontaneous abortion and that can maintain pregnancy until delivery. It was hypothesized that this herbal medicine can also prolong allograft survival after organ transplantation. Here, in an in vivo study, we report the anti-rejection effect of the ethanol extract of Poria cocos Wolf (EEPCW) in rats after cardiac allograft implantation.</p><p><b>METHODS</b>Ten normal rats were healthy controls. Eighty rats receiving homologous heart transplants were divided into 4 groups of 20 rats each based on type of treatment: olive oil 8 ml.kg(-1).d(-1), EEPCW 25 mg.kg(-1).d(-1), EEPCW 50 mg.kg(-1).d(-1) or cyclosporin A 5 mg.kg(-1).d(-1). Allograft survival was observed in 10 rats from each group. On the seventh day post transplantation, pathological lesions and percentages of CD3+, CD4+, and CD8+ lymphocytes and the CD4+/CD8+ ratio in peripheral blood were assessed in another 10 rats from each group and in 10 normal rats.</p><p><b>RESULTS</b>The survival time of donor hearts in the two EEPCW groups was significantly prolonged, to (15.9 +/- 2.4) days and (30.0 +/- 0.0) days, respectively, compared with (6.7 +/- 0.8) days in the control group. Pathological lesions in the two EEPCW groups were also less severe, and the percentages of CD3+, CD4+, and CD8+ lymphocytes and CD4+/CD8+ ratio were significantly lower in the EEPCW groups.</p><p><b>CONCLUSIONS</b>Acute rejection of heart transplants and cellular immune reaction can be effectively suppressed using the EEPCW. Taking advantage of novel immunosuppressants derived from Chinese medicinal herbs used to treat abnormal pregnancy provides a hopeful road for future research and treatment in organ transplantation.</p>

Three cases of orthotopic heart transplantation surviving more than 10 years / 中华器官移植杂志

Objective To summarize the experience of long-term survival of the patients under- going orthotopic heart transplantation.Methods Heart transplantation was performed on 2 cases of dilated cardiomyopathy and one case of Keshan disease.Before operation,pulmonary artery pressure was 42-53 mm Hg(5.60-7.07 kPa)and pulmonary vascular resistance 5.6-7.0 wood.The body weight difference between donors and receptors was 10%-15%.There were three same antigens in HLA zygosity experiment for all of three patients.Two cases were subjected to standard heart trans- plantation and one case to whole heart transplantation.All the atriums and big vessels were sutured by evting suture method.Cyclosporin A,azathioprine and corticosteroid were used to prevent patients from rejection.Results Survival time of 3 patients was 13 years and 10 months,12 years and 10 years and 3 months.Heart functions of three patients were NYHAⅠand all of 3 patients are living and working commonly.Six,3 and 1 rejection(s)occurred in 3 patients respectively and cured by appro- priate treatment.Electrocardiogram revealed that case 1 and case 2 had two P waves and case 3 sinus rhythm.Ultrasonic cardiogram showed that in case 1 and case 2,the left and right atriums were enlarged and tricuspid valve had slight backstreaming,and in case 3,all of the cardiac chambers were normal and had no backstreaming of tricuspid valve and mitral valve.No abnormal findings were found in 3 cases by 4-9 times of coronary arteriongraphy.Conclusion The important factors for the patients' long-term survival after heart transplantation include the choice of appropriate donors and acceptors, protection of donors' hearts,selection of appropriate operations and suture methods,rational use of im- munosuppressants and prevention of cardiac allograft vasculopathy.