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Early cellular events in the lung allograft

1992; Elsevier BV; Volume: 54; Issue: 6 Linguagem: Inglês

10.1016/0003-4975(92)90072-c

1552-6259

Riad Adoumie, Cyril Serrick, Adel Giaid, Hani Shennib,

Immunotherapy and Immune Responses

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 injuryhejection and MHC class I1 expression.Within 1 to 4 hours of reimplantation, we observed marked influx of polymorphonuclear leukocytes and espite its increasing applicability, lung transplanta-D tion continues to be plagued by numerous challenging problems.In the early postoperative period lung dysfunction remains common.This is usually attributed to ischemia-reperfusion injury, atelectasis, rejection, or infection.Advances in lung preservation techniques have greatly reduced the incidence of early graft dysfunction.These techniques, however, remain largely empirical.Cellular events in the lung allograft after ischemia and reperfusion remain poorly understood.Insult to the lung during the process of harvesting, subsequent ischemia, and implantation can induce an inflammatory response that might affect not only the short-term function of the allograft but also its long-term outcome.Bronchoalveolar lavage (BAL) has gained popularity as a valuable method to study cellular events in the lung and to aid in the diagnosis of various lung pathologies [l, 21.Using this technique Shennib and associates [3-51 were able to demonstrate specific alterations in the phenotype of cells harvested from the bronchoalveolar space in the setting of infection, atelectasis, or rejection.Similarly, Chang and colleagues [6] have recently demonstrated early elevation in BAL levels of interleukin-2 (IL-2), yinterferon (IFN-y), and tumor necrosis factor a (TNF-0) in the setting of rejection and suggested that these could be used as early markers for rejection.There is ample evidence that nonallogenic stimuli such as viral infections might predispose an allograft to rejection [7-111.Although the mechanism for this remains unclear, it has been suggested that infection might result