The Journal of Thoracic and Cardiovascular Surgery, Vol 88, 993-999, Copyright © 1984 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Cyclosporin and bronchial healing in canine lung transplantation
NR Saunders, TM Egan, D Chamberlain and JD Cooper
Long-term bronchial anastomotic healing has been assessed in the canine
lung transplant model with cyclosporin as the primary immunosuppressant.
Early bronchial revascularization was achieved by wrapping an omental
pedicle around the bronchial anastomosis. Ten dogs underwent left lung
transplantation and six survived 100 days or more before being put to
death. No significant bronchial complications occurred. Late
bronchostenosis was not seen, despite four biopsy-proved rejection episodes
in three of the dogs surviving past 100 days. Histologically, all
anastomoses were well healed at autopsy. Cyclosporin was shown to be an
effective immunosuppressant in this model and was associated with prolonged
survival and low morbidity. Transplant lung function was assessed at 100
days by contralateral pulmonary artery ligation in five dogs and was
satisfactory in the three animals that had not had rejection episodes. The
findings support our belief that bronchial anastomotic complications after
human lung transplantation are mainly related to the effects of
immunosuppression with steroids and to the ischemia resulting from division
of the bronchial circulation at the time of transplantation.
