器官移植的發(fā)展與未來

器官移植的發(fā)展與未來臺北榮總一般外科龍藉泉Humanchimera,or“homonovo.”Man’soriginalstructurehasbeenmodifiedsothathecanacceptanorgan“fromelsewhere”MythandLegendMythandLegendMythandLegendMythandLegendProf.V.Demikhovandhistwo-headeddog.phototakentwodaysaftertheoperation

U.S.S.R(1950)MAINSTEPSINGRAFTHISTORYTHEPLANTGRAFT:VERYEARLYINMAN’SHISTORYTHEANIMALGRAFT:18THCENTRURYTHEHUMANGRAFT:18THCENTURYORGANTRANSPLANTATION:20THCENTURYFROMGARDENTOFARMYARDFROMGARDENTOFARMYARD19THCENTURY:ALLFROMSOFGRAFTSBoronio’ssheep(1804).Successfulreplacementskingraftsonthebackofanewe.PaulBertnexttoClaudeBernard,performingavivisectionprocedureinhislaboratoryattheCollegeofFrancein1889.Freesplit-skingraftonaburnoftheshoulderandarm.THEKIDNEY:APILOTORGANTHEFIRSTTRANSPLANTATIONINANIMALAttheViennaMedicalSocietymeetingheldinJanuary1902,thesurgeonEmerichUllmannreportedthefirstcaseofrenaltransplantationperformedintheneckofadog.Theureter,broughtouttotheskin,oozeda“l(fā)iquidwhichresembleurine”overaperiodoffivedays.Dr.AlexisCarrel––AmagicianFirstrenaltransplantationsinman:1906-1913In1906,MathieuJaboulayperformedrenaltransplantationinman.Hetransplantedtheleftkidneyofapig,killed3hourspreviously,intotheleftelbowofawomansufferingfromnephroticsyndrome.Thegraftremovedonthethirddayandthevesselswerefoundtobeobstructedbyclots..Firsttransplantationbetweenhumans:1933In1933,therussiansurgeonVoronoy(1896-1961)performedthefirsthomologousrenaltransplantationinmanusingahumancadaverkidney.SergeVoronoff,attheCollègedeFrance.Testiculartransplantationfromamonkeytoman.Aretiredindianarmycolonelinfineformaftertheoperation.TheBrighamcommando:1947Ayoungwomanwasinprofoundcomawithanuriafor10daysfollowinganabortioncomplicatedbyacutetubulopathyduetosepticshockandincompatibletransfusion.DavidM.Hume(1917-1973)Paris,Christmas1952:thepresentfromamothertohersonMrsRenardandhersonMariustowhomshedonatedakidneyinDecember1952.Pelvicimplantationofthekidneywithrestorationoftheurinarytract.ArealSuccess:1954JohnMerrillandJosephMurry(NobelPrize1991)attheBrighamin1953Firstsusccessfultransplantationbetweentwoidenticaltwinsin1954bytheMurry,MerrillandHarrisonteam.PeterBrianMedawar,NobelPrizein1960.Rejectionwasbytheactionoflymphocyteswhichdescribedas““immunocomeptentcells““MAJORHISTOCOMPATIBILITYCOMPLEX:1952(JeanDausset,NobelPrizein1980)(HumanMHC)Immunosuppression:TotalBodyIrradiation“Sam””and““HonestJohn””FirstprolongedsurvivalofrenaltransplantationwithanunrelateddonorMrsGenandherdonoratFochHospitalin1960DevelopmentofImmunosuppressiveDrugsMarianneMattlaerwith““Mana””,whoreceivedakidneyin1960withimmunosuppressionbyazathioprine,withalittertowyearsafterthetransplantation.AdventofCyclosporineTheprimitivefungusfromwhichcyclosporineisextracted(Tolypocladiuminflatum)SirRoyCalneProgressinHemodialysisWilliamJ.Kolff,fatheroftheartificialkidneyandheart.ThefirstartificialkidneydesignedbyKolffin1945.TissueTyping“Thecentreeffect””:TerasakiandstatisticsOrganPreservationFalkertO.Belzer.ThefirsthumankidneypreservedonaperfusionmachinepriortotransplantationinAugust1967.OrganPreservationLiverTransplantationThomasStarzlintheoperatingroomonMarch1,1963,performedthefirstlivertransplantation,therecipientsurvivedfivehoursafterthetransplantation.OilpaintingbySirRoyCalne(1990)representaphaseoflivertransplantationcoordinatedbytheentiresurgicalteam.PancreasandIntestinalTransplantationRichardLilleheiHeartandLungTransplantationDeniseDarvall,thefirsthumanheart”donor”LouisWashkansky,theheartrecipient.December3,1967.ChristiaanN.Barnard,cardiovascularsurgeonatCapetown.ArtificialHeartHeartandLungTransplantationJamesD.Hardy’steam,performedthefirsthumanlungtransplantationonJune11,1963,sevenandahalfmonthsbeforetheyperformedthefirsthumanheterologushearttransplantation.XenotransplantationThefirstbloodtransfusionfromanimalstomanwereattemptedin1628.Xenotransplantation器官移植植在臺灣灣的發(fā)展展臺臺大李李俊仁自體骨髓臺臺大大陳陳耀昌昌異體骨髓臺臺大大陳陳耀昌昌長長庚陳陳肇隆長長庚陳陳肇隆臺臺大朱朱樹勳北北榮王王良順臺灣器官移植植之父臺灣肺臟移植植的先驅(qū)王良順教授，，臺北榮總呼呼吸加護病房房主任Howthetransplantationisdoing?Howthetransplantationisdoing?SPKTFromDonortoRecipientFrom8AMto2AM09/20/2003LiverandPancreasinBackTableY-graftReconstructionSMASAEIAIIACIAPancreasTransplantationCold/WarmIschemicTime=452min/38minPVDuodenumgraftY-grafta.PancreasgraftDuodeno-jejunostomyinSPKTPancreasSPKTon09/19/2003Pancreatico-DuodenalgraftKidneygraftJejunumFirst24hoursBloodSugarafterSPKTFirstMonthBloodSugarafterSPKTRenalFunctionafterSPKTSPKTHappyDischargeon10/09/2003Wherearewegoingto?ImmuneToleranceXenograftStemCellArtificialOrganImmuneToleranceImmuneToleranceStemCellsStemCellsArtificialOrganXenotransplantation美麗新世界的的來臨總是需要更多多的心去參與9、靜夜夜四無無鄰，，荒居居舊業(yè)業(yè)貧。。。12月月-2212月月-22Thursday,December22,202210、雨雨中中黃黃葉葉樹樹，，燈燈下下白白頭頭人人。。。。14:06:3114:06:3114:0612/22/20222:06:31PM11、以我獨獨沈久，，愧君相相見頻。。。12月-2214:06:3114:06Dec-2222-Dec-2212、故人江江海別，，幾度隔隔山川。。。14:06:3114:06:3114:06Thursday,December22,202213、乍見見翻疑疑夢，，相悲悲各問問年。。。12月月-2212月月-2214:06:3114:06:31December22,202214、他鄉(xiāng)生白白發(fā)，舊國國見青山。。。22十二二月20222:06:31下下午14:06:3112月-2215、比不了得得就不比，，得不到的的就不要。。。。十二月222:06下下午12月-2214:06December22,202216、行動出成成果，工作作出財富。。。2022/12/2214:06:3114:06:3122December202217、做做前前，，能能夠夠環(huán)環(huán)視視四四周周；；做做時時，，你你只只能能或或者者最最好好沿沿著著以以腳腳為為起起點點的的射射線線向向前前。。。。2:06:31下下午午2:06下下午午14:06:3112月月-229、沒有失敗，，只有暫時停停止成功！。。12月-2212月-22Thursday,December22,202210、很多事情情努力了未未必有結(jié)果果，但是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