Early cellular events in the lung allograft.
We hypothesized that ischemic insult to the lung allograft may render it more susceptible to rejection. Left canine single-lung allografts were subjected to usual periods of cold and warm ischemia (4 hours and 1 hour, respectively). Bronchoalveolar lavage and open lung biopsies were performed at 0, 1, 4, and 24 hours and 1 week after transplantation. Bronchoalveolar lavage fluid was examined for cellular phenotypes, lymphocyte lectin-mediated cytotoxicity, and natural killer cell cytotoxicity. Open lung biopsy specimens were examined for severity of injury/rejection and MHC class II expression. Within 1 to 4 hours of reimplantation, we observed marked influx of polymorphonuclear leukocytes and lymphocytes and an increase in lectin-mediated cytotoxicity (25.6% +/- 14.8% and 50.6% +/- 20.1% versus 5.4% +/- 7.5% preoperatively; p < 0.05). In addition, natural killer cell cytotoxicity increased from 10.2% +/- 13.5% before transplantation to 20.5% +/- 8.6% 4 hours after transplantation (p < 0.03). By 24 hours MHC class II expression became evident and continued to increase while subtle histologic evidence of rejection appeared by 1 week. We conclude that ischemia-reperfusion injury can alter the local bronchopulmonary milieu, thus rendering it more susceptible to the development of rejection.
Adoumie
R
R
Joint Marseille-Montreal Lung Transplant Program, Quebec, Canada.
Serrick
C
C
Giaid
A
A
Shennib
H
H
D000818:Animals; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D003601:Cytotoxicity Tests, Immunologic; D004195:Disease Models, Animal; D004285:Dogs; D005069:Evaluation Studies as Topic; D015870:Gene Expression; D005802:Genes, MHC Class II; D006084:Graft Rejection / Q000097:blood / Q000276:immunology / Q000473:pathology*; D006801:Humans; D016130:Immunophenotyping; D007165:Immunosuppression Therapy / Q000379:methods; D007694:Killer Cells, Natural; D007958:Leukocyte Count; D016040:Lung Transplantation / Q000276:immunology / Q000473:pathology*; D009504:Neutrophils; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets; D013602:T-Lymphocytes, Cytotoxic; D013997:Time Factors