Morphometric examination of native lungs in human lung allograft recipients.
The aim of the study was to estimate the degree of lung damage in patients with alpha(1)-antitrypsin (alpha1AT) deficiency, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) at the time of lung transplantation. Using unbiased stereological methods, lung-, bronchial- and vessel-volume, capillary length, and alveolar surface area and densities were estimated in recipient lungs from 21 consecutive patients with pre-transplant diagnoses including COPD (n=7), alpha1AT deficiency (n=6) and CF (n=8). Six unused adult donor lungs served as controls. Information relating to patient demography and pre-transplant lung function was obtained by retrospective chart review. Disease groups differed significantly with respect to demographics and pre-transplant lung function. Total lung volume was similar in all groups. Bronchial volume was significantly larger in CF patients compared to the control group (p<0.0001) and to the other two diagnostic groups: alpha1AT deficiency (p=0.0001) and COPD (p<0.0001). Alveolar surface density and capillary length density were significantly lower in patients with alpha1AT deficiency and COPD compared to controls (p<0.0001, respectively) and to patients with CF (p<0.0002, respectively). There were no correlations between clinical lung function and morphometric measurements. We conclude that unbiased microscopic stereological morphometry is an evolving science with the potential to elucidate pulmonary disease pathogenesis.
Wiebe
B M
BM
Department of Pathology, Herlev Hospital, Denmark.
Burton
C M
CM
Milman
N
N
Iversen
M
M
Andersen
C B
CB
D000328:Adult; D003550:Cystic Fibrosis / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000473:pathology* / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000473:pathology / Q000601:surgery; D019896:alpha 1-Antitrypsin Deficiency / Q000473:pathology / Q000601:surgery