Zpřesnění tkáňové diagnostiky v transplantačním programu

• Thesis title in Czech: Zpřesnění tkáňové diagnostiky v transplantačním programu
• Thesis title in English: Refinement of tissue diagnostics in the transplant program
• Key words: borderline rejekční změny, idiopatická plicní hypertenze, plicní megakaryocyty, transplantace dělohy, transplantace plic.
• English key words: borderline rejection, idiopathic pulmonary hypertension, lung transplantation, pulmonary megakaryocytes, uterus transplantation.
• Academic year of topic announcement: 2020/2021
• Thesis type: dissertation
• Thesis language: čeština
• Department: Department of Pathology and Molecular Medicine (13-321)
• Supervisor: prof. MUDr. Josef Zámečník, Ph.D.
• Author: hidden - assigned and confirmed by the Study Dept.
• Date of registration: 16.10.2020
• Date of assignment: 16.10.2020
• Confirmed by Study dept. on: 15.12.2020
• Date and time of defence: 08.06.2023 11:30
• Date of electronic submission: 14.03.2023
• Date of submission of printed version: 15.03.2023
• Date of proceeded defence: 08.06.2023
• Opponents: doc. MUDr. Jozef Škarda, Ph.D.

References

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Preliminary scope of work

V této práci se zabýváme tkáňovou diagnostikou transplantovaných orgánů pocházejících od dárců i příjemců. U darovaných orgánů (graftů) jsme se zaměřili na upřesnění dosud provizorního skórovacího systému rejekčních změn v programu transplantace dělohy. Pomocí histopatologické diagnostiky, včetně imunohistochemických metod, jsme porovnali nálezy lymfocytárních infiltrátů uváděných ve zmíněném skórovacím systému s nálezy v resekátech děloh žen po hysterektomii provedené z důvodů nesouvisejících s děložním hrdlem. Cílem naší práce bylo ověřit platnost tzv. kategorie borderline změn – morfologický obraz těchto změn se však ukázal být překryvným s fyziologickým nálezem ve zdravém děložním hrdle a tudíž nevyžadujícím imunosupresivní terapii. U orgánů příjemců jsme se zaměřili na roli plicních megakaryocytů v explantátech po transplantaci plic. Cílem bylo přispět k ozřejmění patogeneze chorob vedoucích k nutnosti této transplantace. Plicní megakaryocyty jsme histopatologicky a imunohistochemicky mapovali ve vzorcích plicních explantátů příjemců s různými základními plicními chorobami a objevili jejich výrazně zvýšenou účast u vaskulárních plicních lézí. U idiopatické plicní hypertenze by tento nález mohl pomoci vysvětlit dosud kryptogenní cévní přestavbu. Tato práce ukazuje, že v obou oblastech transplantační medicíny má histopatologické vyšetření stále důležitou úlohu a poskytuje transplantačnímu týmu cenné a jiným způsobem nezjistitelné informace.

Preliminary scope of work in English

The thesis describes tissue diagnostics of organ transplants of the donor as well as recipient. In case of donated organs (grafts), it aims to improve the provisional scoring system of graft rejection after uterine transplantation. Using histopathological methods including immunohistochemistry, it compares lymphocytic population classified in the scoring system with histopathological findings within the resected uteri of women who underwent hysterectomy for benign reasons. The aim was to validate the necessity of the category of so called borderline changes, whose morphology was proven to overlap with physiological finding within healthy uterine cervix. Therefore, there is no need for immunosuppressive therapy in such cases. In case of recipients, the thesis investigates the role of pulmonary megakaryocytes in explanted lungs after transplantation. The idea was to elucidate pathogenesis of the diseases leading to the need of transplantation itself. Pulmonary megakaryocytes within explanted lungs of various recipients were mapped using histopathological methods and immunohistochemistry. The strikingly increased number of such cells was detected among vascular disorders, especially idiopathic pulmonary hypertension. This finding could contribute to the explanation of vascular remodelling in this so far cryptogenic disease. In both cases, this thesis shows the importance of histopathological examination, which provides valuable information to the transplant team, undetectable via another method.