Ferret Lung Transplant: An Orthotopic Model of Obliterative Bronchiolitis

• Published in: American journal of transplantation Vol. 13; no. 2; pp. 467 - 473
• Main Authors: Sui, H., Olivier, A. K., Klesney‐Tait, J. A., Brooks, L., Tyler, S. R., Sun, X., Skopec, A., Kline, J., Sanchez, P. G., Meyerholz, D. K., Zavazava, N., Iannettoni, M., Engelhardt, J. F., Parekh, K. R.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley 01.02.2013; Wiley Subscription Services, Inc
• Subjects: Animals; Biological and medical sciences; Bronchiolitis obliterans; Bronchiolitis Obliterans - diagnosis; Chronic obstructive pulmonary disease, asthma; chronic rejection; Disease Models, Animal; Ferrets; Fibrosis; Graft Rejection; Immunosuppressive Agents - pharmacology; Immunosuppressive Agents - therapeutic use; lung; lung transplant; Lung Transplantation - methods; Lungs; Lymphocytes - cytology; Medical sciences; Mustela putorius furo; Pneumology; Skin & tissue grafts; Sputum; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tomography, X-Ray Computed - methods; Transplantation, Homologous; Transplants & implants; Fissipedia; Carnivora; Orthotopic; Respiratory disease; lung transplant; Lung; Homotransplantation; chronic rejection; Respiratory system; Rejection; Orthotopic transplantation; Vertebrata; Chronic; Mammalia; Treatment; Surgery; Ferret; Graft; Bronchus disease; Bronchiolitis obliterans; Models
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2012.04337.x

Obliterative bronchiolitis (OB) is the primary cause of late morbidity and mortality following lung transplantation. Current animal models do not reliably develop OB pathology. Given the similarities between ferret and human lung biology, we hypothesized an orthotopic ferret lung allograft would develop OB. Orthotopic left lower lobe transplants were successfully performed in 22 outbred domestic ferrets in the absence of immunosuppression (IS; n = 5) and presence of varying IS protocols (n = 17). CT scans were performed to evaluate the allografts. At intervals between 3–6 months the allografts were examined histologically for evidence of acute/chronic rejection. IS protects allografts from acute rejection and early graft loss. Reduction of IS dosage by 50% allowed development of controlled rejection. Allografts developed infiltrates on CT and classic histologic acute rejection and lymphocytic bronchiolitis. Cycling of IS, to induce repeated episodes of controlled rejection, promoted classic histologic hallmarks of OB including fibrosis‐associated occlusion of the bronchiolar airways in all allografts of long‐term survivors. In conclusion, we have developed an orthotopic lung transplant model in the ferret with documented long‐term functional allograft survival. Allografts develop acute rejection and lymphocytic bronchiolitis, similar to humans. Long‐term survivors develop histologic changes in the allografts that are hallmarks of OB. The authors developed an orthotopic model of lung transplantation in the ferret that develops the entire spectrum of lung allograft pathology similar to humans, including acute rejection, lymphocytic bronchiolitis and obliterative bronchiolitis.