Abstract
Left lung homotransplantation was performed in a 31-year-old man in terminal irreversible respiratory failure due to advanced silicosis. Within 10 minutes of completion of transplantation, arterial pO2 rose from 52 to 211 mm. Hg, pCO2 dropped from 90 to 43 mm. Hg, and pH rose from 7.15 to 7.42. On assisted ventilation, arterial O2 tension was maintained within normal limits for the first four days. Thereafter, arterio-alveolar difference for O2 increased to 300 mm. and that for CO2 to 25 mm. Xenon-133 ventilation perfusion ratios confirmed differences between the two lungs. Terminally, bronchopneumonia and hypoxemia were present. Surfactant content of the lung was within normal limits. Postmortem examination revealed bronchopneumonia, bronchial infarction, lymphatic engorgement and mild rejection. Future efforts should emphasize selection of non-infected donors, minimal reliance on steroids for immunosuppression, cardiopulmonary bypass during transplantation, and more definite criteria for rejection.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BAIN B., VAS M. R., LOWENSTEIN L. THE DEVELOPMENT OF LARGE IMMATURE MONONUCLEAR CELLS IN MIXED LEUKOCYTE CULTURES. Blood. 1964 Jan;23:108–116. [PubMed] [Google Scholar]
- CLEMENTS J. A., HUSTEAD R. F., JOHNSON R. P., GRIBETZ I. Pulmonary surface tension and alveolar stability. J Appl Physiol. 1961 May;16:444–450. doi: 10.1152/jappl.1961.16.3.444. [DOI] [PubMed] [Google Scholar]
- DUVOISIN G. E., FOWLER W. S., PAYNE W. S., ELLIS F. H., Jr REIMPLANTATION OF THE DOG LUNG WITH SURVIVAL AFTER CONTRALATERAL PNEUMONECTOMY. Surg Forum. 1964;15:173–175. [PubMed] [Google Scholar]
- ELLIS F. H., Jr, GRINDLAY J. H., EDWARDS J. E. The bronchial arteries. I. Experimental occlusion. Surgery. 1951 Nov;30(5):810–826. [PubMed] [Google Scholar]
- HARDY J. D., WEBB W. R., DALTON M. L., Jr, WALKER G. R., Jr LUNG HOMOTRANSPLANTATION IN MAN. JAMA. 1963 Dec 21;186:1065–1074. doi: 10.1001/jama.1963.63710120001010. [DOI] [PubMed] [Google Scholar]
- HUGGINS C. E. Reimplantation of lobes of the lung. An experimental technique. Lancet. 1959 Dec 12;2(7111):1059–1062. doi: 10.1016/s0140-6736(59)91531-4. [DOI] [PubMed] [Google Scholar]
- JUVENELLE A. A., CITRET C., WILES C. E., Jr, STEWART J. D. Pneumonectomy with replantation of the lung in the dog for physiologic study. J Thorac Surg. 1951 Feb;21(2):111–115. [PubMed] [Google Scholar]
- MAGOVERN G. J., YATES A. J. HUMAN HOMOTRANSPLANTATION OF LEFT LUNG: REPORT OF A CASE. Ann N Y Acad Sci. 1964 Nov 30;120:710–728. doi: 10.1111/j.1749-6632.1964.tb34764.x. [DOI] [PubMed] [Google Scholar]
- MARCHAND P., GILROY J. C., WILSON V. H. An anatomical study of the bronchial vascular system and its variations in disease. Thorax. 1950 Sep;5(3):207–221. doi: 10.1136/thx.5.3.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
- PAULSON D. L., SHAW R. R. Results of bronchoplastic procedures for bronchogenic carcinoma. Ann Surg. 1960 May;151:729–740. doi: 10.1097/00000658-196005000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- TRUMMER M. J. BIBLIOGRAPHY OF LUNG TRANSPLANTATION. Transplantation. 1965 Mar;3:275–278. [PubMed] [Google Scholar]
- WALDHAUSEN J. A., GIAMMONA S. T., KILMAN J. W., DALY W. J. EFFECT OF TRANSPLANTATION OF CANINE LUNG ON PULMONARY COMPLIANCE AND SURFACTANT. JAMA. 1965 Mar 22;191:1002–1005. doi: 10.1001/jama.1965.03080120036009. [DOI] [PubMed] [Google Scholar]
- YEH T. J., ELLISON L. T., ELLISON R. G. ALVEOLAR SURFACTANT IN LUNG HOMOTRANSPLANTATION AND HILAR STRIPPING. Surg Forum. 1964;15:191–192. [PubMed] [Google Scholar]