HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dowling, R. D. Articles by Hardesty, R. L. Search for Related Content PubMed PubMed Citation Articles by Dowling, R. D. Articles by Hardesty, R. L.

The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 767-772, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Donor-transmitted pneumonia in experimental lung allografts. Successful prevention with donor antibiotic therapy

RD Dowling, M Zenati, SA Yousem, AW Pasculle, RL Kormos, JA Armitage, BP Griffith and RL Hardesty
Department of Surgery, University of Pittsburgh, Pa.

Bacterial pneumonia is the most common cause of early morbidity and mortality (less than 2 weeks) after heart-lung transplantation. The majority (76%) of cultures taken from human donor tracheas at the time of explant grew bacteria. The abnormal immune response of the lung allograft and the common finding of bacterial contamination of lung donors led us to hypothesize that clinically silent bacterial contamination of the donor lung progresses to pneumonia in the recipient and that antibiotic treatment of donors will prevent the development of pneumonia in the recipient. Inocula of Streptococcus pneumoniae were instilled into the left middle lobe of normal and donor dogs to identify the number of bacteria that would result in pneumonia in a normal animal and the amount that, when given to a donor, would result in pneumonia in the recipient. Initial studies established that inocula of 10(4) colony-forming units of S. pneumoniae did not result in pneumonia in normal or immunosuppressed animals. When 10(4) colony- forming units or as few as 10(2) were instilled into the left middle lobe of donors 24 hours before explantation and use of the lung for transplantation, severe acute bronchopneumonia developed in all 18 recipients. Treatment of donors with aerosol and intravenous antibiotics, but not with either alone, prevented pneumonia in the recipients. We conclude that bacterial contamination of the donor lung leads to pneumonia in recipients. Intravenous and aerosol antibiotic treatment of donors with bacterial contamination prevents pneumonia in canine lung recipients. Treatment of human donors with this antibiotic regimen may decrease the prevalence of early bacterial pneumonia.

This article has been cited by other articles:

				D. J. Kutsogiannis, G. Pagliarello, C. Doig, H. Ross, and S. D. Shemie Medical management to optimize donor organ potential: review of the literature: [Traitement medical pour optimaliser le potentiel de don d'organe : une revue documentaire]. Can J Anesth, August 1, 2006; 53(8): 820 - 830. [Abstract] [Full Text] [PDF]

				V. Waters, S. Sokol, B. Reddy, G. Soong, J. Chun, and A. Prince The Effect of Cyclosporin A on Airway Cell Proinflammatory Signaling and Pneumonia Am. J. Respir. Cell Mol. Biol., August 1, 2005; 33(2): 138 - 144. [Abstract] [Full Text] [PDF]

				M. de Perrot, W. Weder, G.A. Patterson, and S. Keshavjee Strategies to increase limited donor resources Eur. Respir. J., March 1, 2004; 23(3): 477 - 482. [Abstract] [Full Text] [PDF]

				V. S. Avlonitis, A. Krause, L. Luzzi, H. Powell, J. A. Phillips, P. A. Corris, F. K. Gould, and J. H. Dark Bacterial colonization of the donor lower airways is a predictor of poor outcome in lung transplantation Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 601 - 607. [Abstract] [Full Text] [PDF]

				R. D. Dowling, P. Williams, M. Zenati, B. P. Griffith, and R. L. Hardesty Infections and pathologic factors in the donor lung J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1263 - 1264. [Full Text]