title: Pulmonary infection defense after lung transplantation: does airway ischemia play a role?
abstract: OBJECTIVE
  During a classical lung transplantation procedure, there is no attempt to restore the bronchial circulation, giving rise to ischemia of the mucosa with initial loss of ciliated function. This might compromise the ciliary function and the infection defense mechanisms of the airways.
  
  
  RESULTS
  Although initially the airways are characterized by ischemia (epithelial sloughing), later on, there seems to be a restoration of the ciliary function and up to now, there is no clear evidence that there is an increased risk of infectious episodes due to the lack of bronchial circulation, although this has not extensively been investigated.
  
  
  CONCLUSIONS
  Local pulmonary defense mechanisms after lung transplantation without bronchial revascularization seem to be preserved at least in a stable condition. Whether the loss of bronchial circulation has a negative impact when complications develop (such as bronchiolitis obliterans syndrome) remains speculative.
authors.affiliation: Lung Transplantation Unit and Laboratory, University Hospital Gasthuisberg, Leuven, Belgium. geert.verleden@uzleuven.be
authors.forename: Geert M
authors.initials: GM
authors.lastname: Verleden
authors.forename: Robin
authors.initials: R
authors.lastname: Vos
authors.forename: Dirk
authors.initials: D
authors.lastname: van Raemdonck
authors.forename: Bart
authors.initials: B
authors.lastname: Vanaudenaerde
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001981:Bronchial Arteries / Q000276:immunology / Q000503:physiopathology / Q000601:surgery*; D002923:Cilia / Q000473:pathology; D002925:Ciliary Motility Disorders / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D008168:Lung / Q000098:blood supply* / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects*; D011652:Pulmonary Circulation; D015427:Reperfusion Injury / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D020545:Respiratory Mucosa / Q000473:pathology / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000209:etiology* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018836:Inflammation Mediators