Early cellular events in the lung allograft

• Published in: The Annals of thoracic surgery Vol. 54; no. 6; pp. 1071 - 1077
• Main Authors: Adoumie, Riad, Serrick, Cyril, Giaid, Adel, Shennib, Hani
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.12.1992
• Subjects: Animals; Biopsy; Bronchoalveolar Lavage Fluid - cytology; Bronchoalveolar Lavage Fluid - immunology; Cytotoxicity Tests, Immunologic; Disease Models, Animal; Dogs; Evaluation Studies as Topic; Gene Expression; Genes, MHC Class II; Graft Rejection - blood; Graft Rejection - immunology; Graft Rejection - pathology; Humans; Immunophenotyping; Immunosuppression - methods; Killer Cells, Natural; Leukocyte Count; Lung Transplantation - immunology; Lung Transplantation - pathology; Neutrophils; Severity of Illness Index; T-Lymphocyte Subsets; T-Lymphocytes, Cytotoxic; Time Factors
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/0003-4975(92)90072-C

We hypothesized that ischemic insult to the lung allograft may render it more susceptible to rejection. Left canine single-lung allografts were subjected to usual periods of cold and warm ischemia (4 hours and 1 hour, respectively). Bronchoalveolar lavage and open lung biopsies were performed at 0,1, 4, and 24 hours and 1 week after transplantation. Bronchoalveolar lavage fluid was examined for cellular phenotypes, lymphocyte lectin-mediated cytotoxicity, and natural killer cell cytotoxicity. Open lung biopsy specimens were examined for severity of injury/rejection and MHC class II expression. Within 1 to 4 hours of reimplantation, we observed marked influx of polymorphonuclear leukocytes and lymphocytes and an increase in lectin-mediated cytotoxicity (25.6% ± 14.8% and 50.6% ± 20.1% versus 5.4% ±7.5% preoperatively; ( p < 0.05). In addition, natural killer cell cytotoxicity increased from 10.2% ± 13.5% before transplantation to 20.5% ± 8.6% 4 hours after transplantation ( p < 0.03). By 24 hours MHC class II expression became evident and continued to increase while subtle histologic evidence of rejection appeared by 1 week. We conclude that ischemia-reperfusion injury can alter the local bronchopulmonary milieu, thus rendering it more susceptible to the development of rejection.