Bronchial artery revascularization affects graft recovery after lung transplantation.
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.
Nowak
Kai
K
Department of Experimental Surgery, University of Heidelberg, Heidelberg, Germany.
Kamler
Markus
M
Bock
Matthias
M
Motsch
Johann
J
Hagl
Siegfried
S
Jakob
Heinz
H
Gebhard
Martha-Maria
MM
D000469:Alkaline Phosphatase / Q000032:analysis; D000818:Animals; D001981:Bronchial Arteries / Q000503:physiopathology* / Q000601:surgery*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D004195:Disease Models, Animal; D004285:Dogs; D004727:Endothelium / Q000503:physiopathology; D058851:GPI-Linked Proteins; D006085:Graft Survival / Q000502:physiology*; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008168:Lung / Q000503:physiopathology / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008666:Metalloendopeptidases / Q000032:analysis; D011652:Pulmonary Circulation / Q000502:physiology; D012083:Renin / Q000032:analysis; D015427:Reperfusion Injury / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors; D014656:Vascular Surgical Procedures
D058851:GPI-Linked Proteins; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; C058479:carboxypeptidase M; D012083:Renin; D008666:Metalloendopeptidases