Do mature pulmonary lobes grow after transplantation into an immature recipient?

Duebener, Lennart F.; Takahashi, Yutaka; Wada, Hiromi; Tschanz, Stefan A.; Burri, Peter H.; Schäfers, Hans-Joachim (1999). Do mature pulmonary lobes grow after transplantation into an immature recipient? The Annals of Thoracic Surgery, 68(4), pp. 1165-1170. Elsevier 10.1016/S0003-4975(99)00724-9

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BACKGROUND The use of reduced-size adult lung transplants could help solve the profound pediatric donor lung shortage. However, adequate long-term function of the mature grafts requires growth in proportion to the recipient's development. METHODS Mature left lower lobes from adult mini-pigs (age: 7 months; mean body weight: 30 kg) were transplanted into 14-week-old piglets (mean body weight: 15 kg). By the end of the 14-week holding period, lungs of the recipients (n = 4) were harvested. After volumetric measurements, the lung morphology was studied using light microscopy, scanning, and transmission electron microscopy. Changes of alveolar airspace volume were determined using a computer aided image analysis system. Comparisons were made to age- and weight-matched controls. RESULTS Volumetric studies showed no significant differences (p = 0.49) between the specific volume (mL/kg body weight) of lobar grafts and left lower lobes of adult controls. Morphologic studies showed marked structural differences between the grafts and the right native lungs of the recipients, with increased average alveolar diameter of the grafts. On light microscopy and scanning electron microscopy, alveoli appeared dilated and rounded compared to the normal polygonal shape in the controls. The computer generated semi-quantitative data of relative alveolar airspace volume tended to be higher in transplanted lobes. CONCLUSIONS The mature pulmonary lobar grafts have filled the growing left hemithorax of the developing recipient. Emphysema-like alterations of the grafts were observed without evidence of alveolar growth in the mature lobar transplants. Thus, it can be questioned whether mature pulmonary grafts can guarantee sufficient long-term gas exchange in growing recipients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy

UniBE Contributor:

Tschanz, Stefan A. and Burri, Peter Hermann

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1552-6259

Publisher:

Elsevier

Language:

English

Submitter:

Stefan Andreas Tschanz

Date Deposited:

25 Aug 2014 13:30

Last Modified:

13 Jan 2015 03:12

Publisher DOI:

10.1016/S0003-4975(99)00724-9

PubMed ID:

10543474

BORIS DOI:

10.7892/boris.46876

URI:

https://boris.unibe.ch/id/eprint/46876

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