? ? Transplantation ? ? ?????????????

1
? ? Transplantation? ??????????????
???? (1)
2
??? ????? ??????? ?????????? ????
???? (2)
3
?????(transplantation)
??????????????????????,?????????????????,?????
???? (3)
4
??? ??????? (graft,
transplant) ?? ????????? (donor)
?? ????????,?????
(recipient,host)
???? (4)
5
??????1. ???????????
1902?Albert??????
1905?Carrel???-???? 30????????2.
?????????? 50????
???? (5)
6

???? (6)
1954?Joseph E. Murray?????????
1963?Thomas Starzl???????
7
???? (7)
1967?Christiaan Barnard????????
1966?Richard Lillehei ?William Kelly??? ???????
8
???? (classification)1. ?????????? ????
(autotransplantation) ????
(allotransplantation) ?????? (syngeneic
transplantation) ?????? (homoplastic
transplantation) ???? (xenotransplantatio
n)2. ???????? ???? (viable) ????
(structural)(????)
???? (8)
9
3. ?????? ???? (free or dissociated)
???? (pedicle) ???? (anastomosed or
vascularized) ???? (infused)4. ???????
???? (orthotopic) ???? (heterotopic)
????? (paratopic)
???? (9)
10
5. ???????? ???? (cellular) ????
(tissue) ???? (organ)
???? (10)
11
???? (cellular transplantation)
?????????????,???????????????,??????
???? (11)
12
??1. ?????????????????2. ????????????????3.
???????,??????,??? ?????4.
?????????????????? ?????5.
????????????,???????6. ???????????????,???
???????
???? (12)
13
??????? 1. ?? 2. ???? 3. ?????? 4.
????? 5. ?????
???? (13)
14
???? (14)
??????
15
???? (15)
??????
16
???? (16)
??????
17
???? (17)
????
18
???? (18)
???????
19
???? (19)
?????
20
???? (tissue transplantation)
??????????????????????,?????,??????
???? (20)
21
??????? 1. ???? 2. ???? 3. ???? 4. ????
5. ???? 6. ????
???? (21)
22
7. ????8. ????9. ????10.???11.????12.?????13
.??????
???? (22)
23
???? (23)
24
???? (24)
25
???? (25)
26
???? (26)
27
???? (27)
28
???? (28)
????
29
???? (organ transplantation)
??????????????????????,?????,???????????,??????
???? (29)
30
???? (30)
??? ????? ??????? ?????????? ????
31

???? (31)
???????? 1. ???? ?
MHC?????????(HLA) ? ????????(nH??)
? ????
32
???? (32)
2. ????????? ?????,??????,???????
(B???T??)???,?????????,??????????????????????????
33
???? (33)
????????
T??
?????
??????
??????
?????
? ?
? ?
? ?
B??
???
??????? ????
??????
34
3.???? ??????,????????
???????????4.???? ?????????,?????
??????,???????? ????
???? (34)
35
??????????? (1) ???????
(2) ???????? (3) ?????? (4)
??????
???? (35)
36
??????? (hyperacute rejection)
???????????????????,????ABO???????????????????????
???????,???????????,???????,??????????????????????
????,???????24-48??,???????????????,?????????,????
??????????,????
???? (36)
37
????????
(accelerated vascular rejection)
????????,??????????,??????????????????????????????
,????????????????????????????????,?????????
???? (37)
38
?????? (acute rejection)
???,?????T????????????????1???,???????????????????
????????????,????????????,???????????????
???? (38)
39
??????(chronic rejection)
????,????????????????????,????????????????,???????
????????,?????????????,?????????
???? (39)
40
???????? 1. ???????? 2. ???????????????
3. ??????????A? ????(FK506) 4.
???????????????(ALG)? ????-CD3(OKT3)
5. ??RS-61443(??,Cellcept)
???? (40)
41
???? (41)
??? ????? ??????? ?????????? ????
42
??????? ? 1.???????? 2.???????
???? (42)
43
1. ???????? ?????????????,????
???????? ???? (1) ??????????????
(2) ????????????? ????
??????????????????? HIV??
????
???? (43)
44
2. ???????
?????????,?????????????????,???????????(1)???ABO
??????ABO??(2)????????????(3)????????MLC??(4
)HLA??????HLA?? (HLA-A, B, C,
DR,DP,DQ??)
???? (44)
45
?????????? ? 1. ????? ??????????
?? (1) ?????????? (2)
?????????????? ???????
???? (45)
46
2. ????? ???? (1) ???? (2)
????????,?????? (3) ????????????
??????????? ?????Collins?? UW??Ross??
WMO-1???EC??
???? (46)
47
???? (47)
48
???? (48)
49
???? (49)
??? ????? ??????? ?????????? ????
50
????? (renal transplantation)???????????
?,??????????????????????????,??????,???,??????????
??????????,??????????,??????????,?????????

???? (50)
51
???? (51)
52
???? (52)
53
????? (liver transplantation)???
????????,??????????????????????????,??????????(a-?
???????????????????????????????),?????????????????
????????????
???? (53)
54
???? (54)
55
??????? ? ?????
??????? ??????? ??????
??????? ?????? ?????
???? (55)
56
?????-??
???? (56)
57
?????-????
???? (57)
58
?????-????
???? (58)
59
???? (59)
60
???? (60)
61
???? (61)
?????-???????
62
???? (62)
?????-??
63
?????-??????
???? (63)
64
??????(cadiac transplantation)?????????????
??????????,???,???????????????????
???? (64)
65

???? (65)
?????
?????
66
???? (66)
???
67
???? (67)
???
68
?????? (pancreas transplantation)?????ß????????
,???????????????????????????????????,????
1. ?????????? 2. ????????????? 3.
???????????? 4. ??????
???? (68)
69
???? (69)
70
???? (70)
?????????????
71
?????? (intestinal transplantation)
???? (71)
72
???? (72)
????
73
???? (73)
74
???? (74)
?????
75
???? (75)
??????-??????
76
???? (76)
??????-???????
77
???????? ?????????????
(????????????)? ???????????
???? (77)