Early Posttransplantation Complication Pathology in the Experimentally Induced Allograft Lung

Abstract

LUNG allografts are susceptible to a wide variety of airway mediated and vascular mediated insults begin- ning at graft revascularization. 1 Early changes can be observed during the immediate postoperative and periop- erative periods. The survival rate of transplanted lungs is limited by early posttransplantation complications and later obliterative bronchiolitis. 2 Early graft failure and other complications continue to be a major clinical problem after lung transplantation. The aim of this study is to investigate early clinicopathologic changes in the experimentally in- duced allograft lungs. MATERIALS AND METHODS Fifty Korean adult dogs received single allograft lung transplanta- tions (25 pairs). Pathologic evaluation for 22 of the 25 cases was available. All of the autopsy cases (n 5 13) died immediately or soon after transplantation while the others (n 5 9) were sacrificed to investigate the early complication pathology (Table 1). The donor lungs had been preserved for 20 hours at 10°C after flushing with low-potassium dextran glucose (n 5 12), modified Euro- Collins (n 5 9), or University of Wisconsin (n 5 1) solution. Using the transplanted lungs, we investigated gross and light microscopic changes. All lung tissues were fixed in 10% buffered formalin, paraffin-embedded, sectioned 4 mm in thickness. The specimens were then stained with hematoxylin-eosin, trichrome, Gomori’s methenamine silver, Gram’s and Ziehl–Neelsen stains. Cultures were not performed. RESULTS Clinical Features The clinical features of the early posttransplantation com- plications were primary graft failures (4), implantation