[Early diagnosis of acute rejection in single lung transplantation from the standpoint of pulmonary hemodynamics].
The aim of this study is to clarify the early phase of acute rejection of the single lung transplantation by the pulmonary hemodynamics. Twenty dogs were divided into 3 groups (Group I (6 dogs): Modified autotransplantation, Group II (6): Allotransplantation without immunosuppression, Group III (8): Allotransplantation with immunosuppression (CYA 10mg/kg, AZ 2mg/kg)). Cardiac output (CO) and pulmonary arterial (PA) flow of the transplanted lung were measured continuously using Doppler flow method. In Group I, PA flow was maintained at about 40% of CO for 2 weeks. However, in Group II, PA flow gradually decreased to 15% of CO on the 7th postoperative day (POC) and all animals died of rejection within 2 weeks after surgery. In Group III, PA flow decreased to 20% of CO on the 1st POD but, then increased gradually to 38% on the 14th POD. When rejection was induced by discontinuation of CYA and AZ, PA flow decreased to below 13% of CO within 3.7 days (mean) and perivascular cuffing was found in open biopsy, although findings on chest X-ray films remained unchanged. PA flow returned to 40% within 4.3 days (mean) by injecting methylprednisolone for 3 days. In conclusion, the measurement of pulmonary hemodynamics might be useful in the early diagnosis of acute rejection after single lung transplantation.
Yamamoto
H
H
Department of Surgery, Kobe University School of Medicine, Japan.
Yamashita
C
C
Okada
M
M
D000208:Acute Disease; D000818:Animals; D001379:Azathioprine / Q000627:therapeutic use; D002302:Cardiac Output; D016572:Cyclosporine / Q000627:therapeutic use; D004285:Dogs; D006084:Graft Rejection / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D007165:Immunosuppression Therapy; D016040:Lung Transplantation / Q000473:pathology; D011651:Pulmonary Artery / Q000503:physiopathology; D011652:Pulmonary Circulation; D014655:Vascular Resistance
D016572:Cyclosporine; D001379:Azathioprine