Autotransplantation of the lung in sheep

Davies, Lea; Rosser, T. H. L.; West, Linda

doi:10.1097/00007890-196607000-00032

Cited by 3 publications

(4 citation statements)

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“…Thrombosis of the atrium and pulmonary vein, and stenosis at the site of the atrial anastomosis, are frequent complications in spite of extreme care (Benfield and Coon, 1967;Haglin and Arnar, 1969). Davies et al (1965) also report a high mortality rate following autotransplantation of the lung in the sheep due t o venous thrombosis.…”

Section: Discussionmentioning

confidence: 90%

Experience with lung reimplantation in the dog

Takita

1971

Journal of Surgical Oncology

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Experience with autotransplantation of the lung in 30 dogs is presented. The dog can be used for experimental lung transplantation, but it has been extremely difficult to establish a suitable experimental model, Reimplanted lungs of the dog often fail to function normally because of complications involving the vascular and bronchial anastomoses. An angioplastic procedure is essential for the pulmonary arterial anastomosis to assure distensibility of the vessel to avoid high and fixed pulmonary arterial resistance. Special care is also required for the atrial anastomosis to prevent stenosis and thrombosis of the anastomotic site. Because of the preceding difficulties, the dog will not likely be an ideal animal for experimental lung transplantation.

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Section: Discussionmentioning

confidence: 90%

Experience with lung reimplantation in the dog

Takita

1971

Journal of Surgical Oncology

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“…In this series the principal cause of failure was stenosis or thrombosis of the pulmonary veins at the level of the atrial anastomosis. The high incidence of this complication after reimplantation is well established (Yeh et al, 1962;Alican and Hardy, 1963;Nigro et al, 1963;Haglin et al, 1963;Guilmet et al, 1965;Davies et al, 1965). The cephalad and middle veins were more frequently affected than the caudad, stenosis of the former being present in 12 of the 16 dogs.…”

Section: Discussionmentioning

confidence: 96%

Long-term survival of dogs after experimental pulmonary reimplantation and staged contralateral pneumonectomy

Hill

Shaw

1968

Thorax

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Sixteen dogs which survived left pulmonary reimplantation were subjected to staged contralateral pneumonectomy. Complete excision of the right lung was achieved in nine of these animals. There were three long-term survivors, of which two lived for more than three years on the singl$e reimplanted lung. Stenosis of the pulmonary veins at the level of the atrial anastomosis was the commonest post-mortem finding. In the first week after reimplantation, the ventilation and oxygen uptake of the reimplanted lung invariably fell to low levels. These usually rose slowly but to a variable extent over the next six to eight weeks, after which there was little further improvement while the normal lung remained intact. In all three long-term survivors the ventilation and oxygen uptake of the reimplanted lung were more than doubled after contralateral pneumonectomy; the rise in oxygen uptake was less and occurred later than the rise in ventilation. Pulmonary hypertension and pulmonary oedema did not occur except in association with organic obstruction to the pulmonary venous drainage.Survival of experimental animals on a single reimplanted lung is uncommon. The initial operation of pulmonary reimplantation carries a high mortality rate (Blumenstock and Kahn, 1961;Linberg, Demetriades, Armstrong, and Konsuwan, 1961;Yeh, Ellison, and Ellison, 1962;Alican and Hardy, 1963; Nigro, Evans, Benfield, Gaco, Fry, and Adams, 1963;Haglin, Telander, Muzzall, Kiser, and Strobel, 1963;Shaw and Burton, 1964;Borrie and Lichter, 1964;Davies, Rosser, and West, 1965;Guilmet, Brunet, Krakora, Leiva, and Weiss, 1965) Nigro and his colleagues (1961, 1963) were the first to suggest that staged ablation of the opposite lung might increase the chances of an animal surviving on a single reimplanted lung. They reported long-term survival in 5 of 16 dogs successively subjected to right lung reimplantation, left upper lobectomy, and cauterization of the left lower lobe bronchus with silver nitrate. The technique effectively confines gaseous exchanges to the reimplant but it leaves the nerve supply (and possibly the vasculature) of the left lower lobe intact. A staged but complete excision of the opposite lung, therefore, is a more rigorous test of the function of the pulmonary autograft. By resecting the right lung in two or three operations after left pulmonary reimplantation we have achieved long-term survival in 3 of 16 dogs. MATERIAL AND METHODSMongrel dogs of about 20 kg. weight had the left lung reimplanted by a standard method (Neptune, Redondo, and Bailey, 1953;Neptune, Weller, and Bailey, 1953). Sixteen survivors were submitted to staged excision of the right lung, begun at various times between 12 days and 8 months after reimplantation. Dogs which survived the first stage had a second -and sometimes a third-operation at intervals of two to four weeks to complete the right pneumonectomy. The choice and number of lobes removed at each operation depended on the state of the reimplant's function as determined beforehand by bronchospirometry.Period...

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“…Despite all the improvements in transplantation technique, thrombosis of the venous anastomosis is still the most serious complication (Alican and Hardy, 1963;Hardy, Eraslan, and Webb, 1964;Borrie and Lichter, 1964;Davies et al, 1965). Even immaculate venous anastomosis may suffer thrombosis.…”

Section: Discussionmentioning

confidence: 99%

“…Some impressive studies were carried out by several authors in order to establish the function of the reimplanted or transplanted lung, and, although results obtained were varied, it seems that the transplanted lung retains a sufficient 564 degree of function to participate in oxygenation and elimination of carbon dioxide, thus being of value to the recipient (Yeh, Ellison, and Ellison, 1962;Bucherl, Nasseri, and Prondzynski, 1964a;Bucherl, Eisele, Kirsch, K6hn, and Nasseri, 1964b;Davies, Rosser, and West, 1965;Faber, Pevsner, Pedreira, and Beattie, 1965).…”

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confidence: 99%