Richards K

Mechanism and prevention of fixed high vascular resistance in autografted and allografted lungs.

The fixed vascular resistance observed in tranisplanted Ilunlgs and attriblted to denervation can be avoided by angioplastic wideniing of the pulmonary artery anastotosis. With distenisible arterial anrastomoses, aultografted an, d allografted Ilunzgs vasodilate niormzally with inicreased flow and cani sutstaini dogs whose contralateral pulmonary artery is ligated imumediately after lutng transplanitation.

Immediate life support by a single transplanted lung in puppies

Abstract Lung allotransplantation followed immediately by ligation of the opposite pulmonary artery is compatible with survival for at least eight days in 5–10-Kg. puppies if the arterial anastomosis is made distensible and if there are no other technical flaws. The denervated transplanted lung does not necessarily develop congestion, hemorrhage or edema even though it is providing adequate total gas exchange while carrying the entire cardiac output. Technical problems, which are more difficult to prevent in puppies than in adult dogs, can be over-come by suitable precautions. Presently available immunosuppression is insufficient to prevent significant rejection of transplanted lungs with certainty in an outbred population. Ultimately, however, as improved methods for preventing rejection are developed, lung transplantation, as a therapeutic modality, should be feasible in infants and children.