title: Bronchial artery revascularization affects graft recovery after lung transplantation.
abstract: 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.
authors.affiliation: Department of Experimental Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Nowak
authors.forename: Markus
authors.initials: M
authors.lastname: Kamler
authors.forename: Matthias
authors.initials: M
authors.lastname: Bock
authors.forename: Johann
authors.initials: J
authors.lastname: Motsch
authors.forename: Siegfried
authors.initials: S
authors.lastname: Hagl
authors.forename: Heinz
authors.initials: H
authors.lastname: Jakob
authors.forename: Martha-Maria
authors.initials: MM
authors.lastname: Gebhard
mesh_terms: 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
chemical_list: D058851:GPI-Linked Proteins; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; C058479:carboxypeptidase M; D012083:Renin; D008666:Metalloendopeptidases