Bronchial artery revascularization affects graft recovery after lung transplantation

KAI Nowak, M Kamler, M Bock, J Motsch… - American journal of …, 2002 - atsjournals.org
KAI Nowak, M Kamler, M Bock, J Motsch, S Hagl, H Jakob, MM Gebhard
American journal of respiratory and critical care medicine, 2002atsjournals.org
Restitution of bronchial artery circulation might alter ischemia–reperfusion injury and
improve organ function after lung transplantation. Weight-matched dogs underwent a left
lung allotransplantation either with bronchial artery revascularization (BAR; n= 6) or as
conventional lung transplantation (LTX; n= 6), to evaluate effects of BAR on lung cell
function over a period of 5 h postischemically. Lactate dehydrogenase (LDH) and marker
enzymes for pneumocytes type I (carboxypeptidase M [CPM], pneumocytes type II (alkaline …
Restitution of bronchial artery circulation might alter ischemia– reperfusion injury and improve organ function after lung transplantation. Weight-matched dogs underwent a left lung allotransplantation either with bronchial artery revascularization (BAR; n = 6) or as conventional lung transplantation (LTX; n = 6), to evaluate effects of BAR on lung cell function over a period of 5 h postischemically. Lactate dehydrogenase (LDH) and marker enzymes for pneumocytes type I (carboxypeptidase M [CPM], pneumocytes type II (alkaline phosphatase [AP]), and pulmonary endothelium (angiotensin-converting-enzyme [ACE]) were determined from bronchoalveolar lavage fluid. Donor lungs were preserved with Euro-Collins solution. Total ischemic time was kept at 6 h. CPM and LDH activities were significantly higher in both groups at 2 h and 4 h of reperfusion compared with control dogs (p < 0.01). AP and ACE activities in lavage after 2 h of reperfusion were significantly elevated in animals that underwent LTX (AP: 60 ± 28 IU/L; ACE: 1.39 ± 1.13 IU/L) compared with animals with BAR (AP: 33 ± 29 IU/L; ACE: 0.35 ± 0.6 IU/L; p < 0.05) and with control animals (AP: 13.58 ± 11.0 IU/L; ACE: 0.06 ± 0.14 IU/L; p < 0.01). According to these results, BAR protects pulmonary endothelium and type II pneumocytes in the early phase after lung transplantation and might have consequences for lung tissue in the long term.
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