26t~ Annual Congress of the European Society for Surgical Research (ESSR), Walter Brendel Session
our SBTx model, that TNF appears as a consequence of sepsis. We believe it is unlikely, however, that sepsis alone would entirely explain the association of acute GVHD with serum TNF because increasedlevels of TNF were detected as early as day 7, at a time when there is no evidence of sepsis yet. The pathway of TNF releasemight involve an interaction between donor cells and host macrophages. Gamma interferon and interleukin-2 released by alloactivated donor T-helper cells stimulate recipient macrophages to produce TNF. In conclusion, GVHD after SBTx occurs in the absence of detectable anti-recipient CTL in the target lymphoid tissues of the host. GVHD after SBTx is associated, however, with the appearance of TNF in the serum. The intensity and reversibility of this phenomenon correlate with both the clinical severity and the lethality of the GVH response. These results strongly indicate a major pathophysiological role of TNF in GVHD occurringafter SBTx. Because anti-TNF has been shown to prevent GVHD after bone marrow transplantation, we hypothesize that complete inhibition of TNF might similarly ameliorate the detrimental effects of GVHD produced by SBTx.
References (1) Cerottini JC, Engers HD, MacDonald HR: Generation of cytotoxic T-lymphocytes in vivo. Response of normal and immune mouse spleen cells in mixed leukocyte cultures. J Exp Med 1974;140:703. (2) DifloT, Maki T, Balogh K, MonacoAP: GraftVersus-Host Disease in fully allogeneic small bowel transplantation in the rat. Transplantation 1988;47:7. (3) Espevik T, Nissen-Meyer J: A highly sensitive cell line, WEHI 164 clone 13, for measuring cyto-
toxic factor/tumor necrosis factor from human monocytes. J Immunot Methods 1986;95:99. (4) Ferrara JLM,DeegHJ: Mechanisms of Disease: Graft-versus-Host Disease. New Engl J Med 1991 ;324:667. (5) Kirkman RL, LearPA, Madara JL, Tilney NL: Small intestine transplantation intherat. Immunology and function. Surgery 1984;96:280. (6) Michie HR. Guillau PJ, Wilmore DW: Tumor Necrosis Factor and bacterial sepsis. Br J Surg 1989;76:670. (7) Monchik GJ, Russel PS: Transplantation of small bowel in the rat: Technical and immunological considerations. Surgery 1971 ;70:693. (8) Piguet PF, Grau GE, Allet B: Tumor necrosis factor/cachectin is an effector of skin and gut lesions of the acute phase of Graft-vs-Host Disease. J ExpMed 1987;166:1280. (9) Pirenne J,D'Silva M,Hamoir E:The influence ofthe lengthofthe small bowelgraftonthe seventy of graft versus host disease. Microsurgery 1990; 11:303-308.
ACA i 1
Heft 1 / 1991,23. Jahrgang
(10) Pirenne J, Lardinois F, D'Silva M: Relevance of mesenteric lymph nodes to graft versus host disease following small bowel transplantation. Transplantation 1990;50:7l 1. (1 I) Schraut WH: Current status of small bowel transplantation. Gastroenterology 1988;94:525. ( l 2) Schraut WH, Lee KW, Dawson PJ, Hurst RD: Graft versus host disease induced by small bowel allografts. Transplantation 1986;41:286.
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(13) Shalaby MR. Fendly B, Sheehan C: Prevention of graft-versus-host reactions in newbom mice by antibodies to t u m o r necrosis factor-alpha. Transplantation 1989:47:1057. (14) Symington F'W, Pepe MS, Chen AB, Deliganis A: Serum Tumor Necrosis Factor Alpha Associated With Acute GVHD in Humans. Transplantation
1990;50:518.
32. Tagung der Osterreichischen Gesellschaft fiir Chirurgie und der ihr assoziierten Fachgesellschaften Ort und Termin: Feldkirch-Montforthaus, 30. Mai bis 1. Juni 1991. Wissenschaftliches I. Hauptthemen:
Programm:
1. Endokrine Chirurgie 2. Anatomisch-bedingte diagnostische und operationstechnische Probleme und Komplikationen in der Chirurgie 3. Indikation, Technik und Ergebnisse der Metastasenchirurgie
II. Aktuelle Themen: 1. Pr~ioperative MaBnahmen zur Verhinderung perioperativer Komplikationen 2. Mammakarzinom: Brusterhaltung versus Mastektomie 3. Alternative Gallensteintherapie Minimal-invasive Chirurgie.
IIII. Freie Vortr/ige: 1. Z u den H a u p t - und aktuellen Themen (I, II) 2. Das kolorektale Karzinom 3. Benigne Mammaerkrankungen Diagnostik und Therapie
IV. Themen der assoziierten Fachgesellschaften V. Experimentelles Forum VI. Seminar fiir Pflegepersonal VII.
Posterausstellung
VIII. Wissenschaftliche Video
Filme und
Auskiinfte: Sekretariat der Abteilungftir Chirurgie, Landeskrankenhaus, A-6807 Feldkirch, Carinagasse 47, Tel. (05522) 24 5 11-24 00, Telefax: (05522) 25 3 93. Tagungspr/isident: Prof. Dr. G. Zimmermann. Tagungssekret/ire: OA Dr. A. Haid und Dr. G. Miiller.
ACO-Schwerpunktsymposium Veranstalter: Arbeitsgemeinschaft ftir Chirurgische Onkologie der Osterreichischen Gesellschaft ftir Chirurgie (ACO), gemeinsam mit der Osterreichischen Gesellschaft ftir Gastroenterologie und Hepatologie (OGG), Chirnrgische Arbeitsgemeinschaft ftir Onkologie der Deutschen Gesellschaft ftir Chirnrgie (CAO) und der Studiengrnppe Multiple Endokrine Neoplasie Austria (SMENA). Ort und Termin: St. Wolfgang am See - Hotel Post, 27. und 28. September 1991. Thema: "Derzeitiger Stand in Diagnose und Therapie der APUDOME/Carcinoide". Tagungspr/isident: OA Dr. N. H6lbling, II. ChirurgischeAbteilung, Landeskrankenanstalten, A-5020Salzburg, Mtillner HauptstraBe 48. Tagungssekretariat: II. Chirurgische Abteilung, Landeskrankenanstalten' A-5020 Salzburg, Mtillner HauptstraBe 48, Tel. (0662) 31 5 81 / 24 01, 41 05, Telefax: (0662) 31 5 81 /24 03.
