Airway obstruction after autologous reimplantation of the porcine lobe

E. D. McGahren, W. G. Teague, T. L. Flanagan, B. J. White, G. W. Barone, A. M. Johnson, I. L. Kron

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Bronchiolitis obliterans (irreversible small airway obstruction) is a late complication of heart-lung transplantation. Chronic immune rejection is believed to be the major cause of this complication. Our hypothesis was that denervation might contribute to airway obstruction. To test this hypothesis in the absence of immune rejection, we performed a lobectomy of the upper lobe of the left lung and autologous reimplantation of the lower lobe of the left lung in 13 growing pigs. To serve as age-matched controls, six other pigs had sham left thoracotomy and nine others had a lobectomy of the upper lobe of the left lung alone. Nine to 10 weeks after operation, the animals were anesthetized and the lungs mechanically ventilated. The lobes were then isolated in vivo to measure differential transrespiratory mechanics and volumes. Dynamic compliance was significantly lower in the reimplanted lobe than it was in the contralateral right lung. This was the case after lobectomy of the upper lobe of the left lung or sham thoracotomy. Dynamic resistance was significantly higher in the reimplanted lobe than it was in the contralateral right lung and in the left lung after sham thoracotomy. Measurements of extravascular lung water, dry lobe weight, alveolar cross-sectional area, and volumetric proportions of lung parenchyma and alveolar spaces did not demonstrate abnormal structural growth after reimplantation. We conclude that lobectomy of the upper lobe of the left lung and autologous reimplantation of the left lower lobe leads to adverse changes in flow-dependent measurements of airway patency. Changes in bronchomotor regulation imposed by denervation may contribute to airway obstruction after heart-lung transplantation.

Original languageEnglish (US)
Pages (from-to)587-592
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume97
Issue number4
StatePublished - Jan 1 1989
Externally publishedYes

Fingerprint

Replantation
Airway Obstruction
Swine
Lung
Thoracotomy
Heart-Lung Transplantation
Denervation
Extravascular Lung Water
Bronchiolitis Obliterans
Mechanics
Compliance
Weights and Measures

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

McGahren, E. D., Teague, W. G., Flanagan, T. L., White, B. J., Barone, G. W., Johnson, A. M., & Kron, I. L. (1989). Airway obstruction after autologous reimplantation of the porcine lobe. Journal of Thoracic and Cardiovascular Surgery, 97(4), 587-592.

Airway obstruction after autologous reimplantation of the porcine lobe. / McGahren, E. D.; Teague, W. G.; Flanagan, T. L.; White, B. J.; Barone, G. W.; Johnson, A. M.; Kron, I. L.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 97, No. 4, 01.01.1989, p. 587-592.

Research output: Contribution to journalArticle

McGahren, ED, Teague, WG, Flanagan, TL, White, BJ, Barone, GW, Johnson, AM & Kron, IL 1989, 'Airway obstruction after autologous reimplantation of the porcine lobe', Journal of Thoracic and Cardiovascular Surgery, vol. 97, no. 4, pp. 587-592.
McGahren ED, Teague WG, Flanagan TL, White BJ, Barone GW, Johnson AM et al. Airway obstruction after autologous reimplantation of the porcine lobe. Journal of Thoracic and Cardiovascular Surgery. 1989 Jan 1;97(4):587-592.
McGahren, E. D. ; Teague, W. G. ; Flanagan, T. L. ; White, B. J. ; Barone, G. W. ; Johnson, A. M. ; Kron, I. L. / Airway obstruction after autologous reimplantation of the porcine lobe. In: Journal of Thoracic and Cardiovascular Surgery. 1989 ; Vol. 97, No. 4. pp. 587-592.
@article{af38691844fb44558726f1dae720a1dc,
title = "Airway obstruction after autologous reimplantation of the porcine lobe",
abstract = "Bronchiolitis obliterans (irreversible small airway obstruction) is a late complication of heart-lung transplantation. Chronic immune rejection is believed to be the major cause of this complication. Our hypothesis was that denervation might contribute to airway obstruction. To test this hypothesis in the absence of immune rejection, we performed a lobectomy of the upper lobe of the left lung and autologous reimplantation of the lower lobe of the left lung in 13 growing pigs. To serve as age-matched controls, six other pigs had sham left thoracotomy and nine others had a lobectomy of the upper lobe of the left lung alone. Nine to 10 weeks after operation, the animals were anesthetized and the lungs mechanically ventilated. The lobes were then isolated in vivo to measure differential transrespiratory mechanics and volumes. Dynamic compliance was significantly lower in the reimplanted lobe than it was in the contralateral right lung. This was the case after lobectomy of the upper lobe of the left lung or sham thoracotomy. Dynamic resistance was significantly higher in the reimplanted lobe than it was in the contralateral right lung and in the left lung after sham thoracotomy. Measurements of extravascular lung water, dry lobe weight, alveolar cross-sectional area, and volumetric proportions of lung parenchyma and alveolar spaces did not demonstrate abnormal structural growth after reimplantation. We conclude that lobectomy of the upper lobe of the left lung and autologous reimplantation of the left lower lobe leads to adverse changes in flow-dependent measurements of airway patency. Changes in bronchomotor regulation imposed by denervation may contribute to airway obstruction after heart-lung transplantation.",
author = "McGahren, {E. D.} and Teague, {W. G.} and Flanagan, {T. L.} and White, {B. J.} and Barone, {G. W.} and Johnson, {A. M.} and Kron, {I. L.}",
year = "1989",
month = "1",
day = "1",
language = "English (US)",
volume = "97",
pages = "587--592",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Airway obstruction after autologous reimplantation of the porcine lobe

AU - McGahren, E. D.

AU - Teague, W. G.

AU - Flanagan, T. L.

AU - White, B. J.

AU - Barone, G. W.

AU - Johnson, A. M.

AU - Kron, I. L.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - Bronchiolitis obliterans (irreversible small airway obstruction) is a late complication of heart-lung transplantation. Chronic immune rejection is believed to be the major cause of this complication. Our hypothesis was that denervation might contribute to airway obstruction. To test this hypothesis in the absence of immune rejection, we performed a lobectomy of the upper lobe of the left lung and autologous reimplantation of the lower lobe of the left lung in 13 growing pigs. To serve as age-matched controls, six other pigs had sham left thoracotomy and nine others had a lobectomy of the upper lobe of the left lung alone. Nine to 10 weeks after operation, the animals were anesthetized and the lungs mechanically ventilated. The lobes were then isolated in vivo to measure differential transrespiratory mechanics and volumes. Dynamic compliance was significantly lower in the reimplanted lobe than it was in the contralateral right lung. This was the case after lobectomy of the upper lobe of the left lung or sham thoracotomy. Dynamic resistance was significantly higher in the reimplanted lobe than it was in the contralateral right lung and in the left lung after sham thoracotomy. Measurements of extravascular lung water, dry lobe weight, alveolar cross-sectional area, and volumetric proportions of lung parenchyma and alveolar spaces did not demonstrate abnormal structural growth after reimplantation. We conclude that lobectomy of the upper lobe of the left lung and autologous reimplantation of the left lower lobe leads to adverse changes in flow-dependent measurements of airway patency. Changes in bronchomotor regulation imposed by denervation may contribute to airway obstruction after heart-lung transplantation.

AB - Bronchiolitis obliterans (irreversible small airway obstruction) is a late complication of heart-lung transplantation. Chronic immune rejection is believed to be the major cause of this complication. Our hypothesis was that denervation might contribute to airway obstruction. To test this hypothesis in the absence of immune rejection, we performed a lobectomy of the upper lobe of the left lung and autologous reimplantation of the lower lobe of the left lung in 13 growing pigs. To serve as age-matched controls, six other pigs had sham left thoracotomy and nine others had a lobectomy of the upper lobe of the left lung alone. Nine to 10 weeks after operation, the animals were anesthetized and the lungs mechanically ventilated. The lobes were then isolated in vivo to measure differential transrespiratory mechanics and volumes. Dynamic compliance was significantly lower in the reimplanted lobe than it was in the contralateral right lung. This was the case after lobectomy of the upper lobe of the left lung or sham thoracotomy. Dynamic resistance was significantly higher in the reimplanted lobe than it was in the contralateral right lung and in the left lung after sham thoracotomy. Measurements of extravascular lung water, dry lobe weight, alveolar cross-sectional area, and volumetric proportions of lung parenchyma and alveolar spaces did not demonstrate abnormal structural growth after reimplantation. We conclude that lobectomy of the upper lobe of the left lung and autologous reimplantation of the left lower lobe leads to adverse changes in flow-dependent measurements of airway patency. Changes in bronchomotor regulation imposed by denervation may contribute to airway obstruction after heart-lung transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0024588658&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024588658&partnerID=8YFLogxK

M3 - Article

C2 - 2648082

AN - SCOPUS:0024588658

VL - 97

SP - 587

EP - 592

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -