Epithelial and hematopoietic cell chimerism in intestinal allografts

doi:10.1016/j.transproceed.2004.01.107

Transplantation Proceedings

Volume 36, Issue 2, March 2004, Pages 359-360

https://doi.org/10.1016/j.transproceed.2004.01.107 Get rights and content

Abstract

Background

In intestinal transplantation recipient lymphocytes infiltrate the allograft soon after reperfusion. Recently, it has been demonstrated that long-surviving small bowel transplants bear enterocytes of recipient origin. We investigated whether epithelial cells (enterocytes) persisted in long-term allografts based on studies of biopsies.

Methods

The biopsies of four male intestinal transplant recipients of female grafts with a previous graft biopsy positive for recipient enterocytes were examined at least 6 months after previous positive assessment. Using the FISH technique, we searched for Y-chromosome-positive enterocytes in the female allograft.

Results

Recipient male enterocytes were identified in all biopsies at low percentages ranging from 0.18 to 0.26. The lymphocytes within the graft were of both recipient (male) and donor (female) origin.

Conclusion

The four types of cells—enterocytes and lymphocytes of recipient and donor origin—coexist in long-term graft biopsies.

Section snippets

Materials and methods

We studied graft biopsies from four male patients—two adults and two children—who had received a small bowel graft from a female donor. Their respective original diseases were trauma (n = 1), diabetic enteropathy (n = 1), and gastroschesis (n = 2). All patients had undergone a previous graft biopsy that was positive for recipient-derived enterocytes. A time interval of at least 6 months separated the new biopsies from the previous positive ones. We used the FISH technique for the X and Y

Results

Male enterocytes were identified in all graft biopsies. Their percentage was low ranging from 0.18 to 0.26% (average 0.21%). This average value was not significantly different from that in the previous positive biopsies. Although the lamina propria of the same sections was infiltrated mostly by recipient male (XY) lymphocytes, we identified a few female (XX) lymphocytes of donor origin that persisted in the allograft. All positive biopsies were obtained between 300 and 1200 days

Discussion

The FISH technique has been used to demonstrate donor (female) versus recipient (male) origin of cells in transplants. However, it is not sufficient to show whether the cells are epithelial or hematopoietic in origin. Many intraepithelial lymphocytes may be mistaken for enterocytes due to their localization at the epithelial lining. However, use of cytokeratin and CD45 staining resolved these issues. The morphology of the enterocytes, namely, cytokeratin-positive columnar cells with abundant

References (2)

Y. Iwaki et al.
Replacement of donor lymphoid tissue in small bowel transplants
Lancet
(1991)
P. Tryphonopoulos et al.
Host derived enterocytes in intestinal grafts
Transplantation
(2002)

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Physiology of intestinal transplantsEpithelial and hematopoietic cell chimerism in intestinal allografts

Abstract

Background

Methods

Results

Conclusion

Section snippets

Materials and methods

Results

Discussion

Lancet

Host derived enterocytes in intestinal grafts

Transplantation

Physiology of intestinal transplants
Epithelial and hematopoietic cell chimerism in intestinal allografts