Bronchial blood supply after lung transplantation without bronchial artery revascularization.
OBJECTIVE
This review discusses how the bronchial artery circulation is interrupted following lung transplantation and what may be the long-term complications of compromising systemic blood flow to allograft airways.


RESULTS
Preclinical and clinical studies have shown that the loss of airway microcirculations is highly associated with the development of airway hypoxia and an increased susceptibility to chronic rejection.


CONCLUSIONS
The bronchial artery circulation has been highly conserved through evolution. Current evidence suggests that the failure to routinely perform bronchial artery revascularization at the time of lung transplantation may predispose patients to develop the bronchiolitis obliterans syndrome.
Nicolls
Mark R
MR
VA Palo Alto/Stanford University School of Medicine, 3801 Miranda Ave., Palo Alto, California 94304, USA. mnicolls@stanford.edu
Zamora
Martin R
MR
D000714:Anastomosis, Surgical; D000818:Animals; D001981:Bronchial Arteries / Q000503:physiopathology / Q000601:surgery*; D001989:Bronchiolitis Obliterans / Q000209:etiology / Q000503:physiopathology; D006084:Graft Rejection / Q000209:etiology / Q000503:physiopathology; D006085:Graft Survival; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects; D011652:Pulmonary Circulation; D012039:Regional Blood Flow; D015427:Reperfusion Injury / Q000209:etiology / Q000503:physiopathology; D014184:Transplantation, Homologous; D016896:Treatment Outcome