Heart and en-bloc thymus transplantation in miniature swine

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Presentation transcript:

Heart and en-bloc thymus transplantation in miniature swine Douglas R. Johnston, MD, Ashok Muniappan, MD, Ruediger Hoerbelt, MD, Dax A. Guenther, MD, Tsuyoshi Shoji, MD, PhD, Stuart L. Houser, MD, David H. Sachs, MD, Joren C. Madsen, MD, DPhil The Journal of Thoracic and Cardiovascular Surgery Volume 130, Issue 2, Pages 554-559 (August 2005) DOI: 10.1016/j.jtcvs.2005.03.036 Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Miniature swine heart and en-bloc thymus graft. The vasculature of the en-bloc graft is depicted with respect to the right cervical and mediastinal thymic lobes. R.C.T., Right cervical thymus; R.M.T., right mediastinal thymus; LCC, left common carotid artery; RCC, right common carotid artery; LIV, left innominate vein; P.A., pulmonary artery; RITA, right internal thoracic artery; RITV, right internal thoracic vein; RAV, right axillary vein; RAA, right axillary artery; RIJ, right internal jugular vein; IVC, inferior vena cava. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 554-559DOI: (10.1016/j.jtcvs.2005.03.036) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Arterial anatomy of heart and en-bloc thymus grafts. A, Gross specimen of en-bloc graft with display of the anterior view of the heart, right cervical thymus (black arrowhead), and right thoracic thymus (white arrowhead). B, Arterial angiography of en-bloc graft performed by means of infusion of barium into the aortic root (Ao). En-bloc dissection involves preservation of the innominate artery (1), right carotid artery (2), right axillary artery (3), thyrocervical trunk (4), and right internal thoracic artery (5), as well as fine thymic branches to the cervical (black arrowhead) and thoracic (white arrowhead) thymic lobes. Venous return is visualized in the superior vena cava (6). C, Hematoxylin and eosin-stained thymus and heart revealed the presence of barium in the small arteries, confirming perfusion. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 554-559DOI: (10.1016/j.jtcvs.2005.03.036) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Histology of heart and en-bloc thymus graft tolerated for more than 200 days. A, Hematoxylin and eosin (H&E)-stained heart without evidence of acute rejection (International Society for Heart and Lung Transplantation 0/4). B, Hematoxylin and eosin-stained thymus revealing normal cortical and medullary architecture and a Hassals corpuscle (white box and C). The Journal of Thoracic and Cardiovascular Surgery 2005 130, 554-559DOI: (10.1016/j.jtcvs.2005.03.036) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Recipient-type thymopoiesis in thymus grafts. Monoclonal antibody specific for either recipient CD4 or PAA allele was used to follow thymopoiesis of recipient cells in the donor thymus graft. Recipient thymocytes, CD4+CD1+ or PAA+CD1+ double-positive cells, reached levels in the donor thymus comparable with levels seen in the native recipient thymus by postoperative day 100. Data from 2 animals are shown, which are representative. The Journal of Thoracic and Cardiovascular Surgery 2005 130, 554-559DOI: (10.1016/j.jtcvs.2005.03.036) Copyright © 2005 The American Association for Thoracic Surgery Terms and Conditions