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

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Aoki, M. Articles by Wada, H. Search for Related Content PubMed PubMed Citation Articles by Aoki, M. Articles by Wada, H.

European Journal of Cardio-Thoracic Surgery, Vol 5, 561-565, Copyright © 1991 by European Association for Cardio-thoracic Surgery

ARTICLES

Bronchial circulation after experimental lung transplantation: the effect of direct revascularization of a bronchial artery

M Aoki, HJ Schafers, K Inui, N Klipsch, S Demertzis, J Kotzerke, A Haverich and H Wada
Kyoto Chest Disease Research Institute, Kyoto University, Japan.

Direct revascularization of a bronchial artery has been proposed as a measure to alleviate the problem of bronchial ischemia after lung transplantation. To assess the effect of restoration of arterial blood flow to the transplanted bronchus, bronchial mucosal blood flow was measured in a model of modified unilateral lung transplantation in pigs. Laser Doppler velocimetry (LDV) and radioisotope studies using radio-labeled erythrocytes (RI) were used to measure blood flow at the donor main carina (DC) and upper lobe carina (DUC) after 3 h of reperfusion. The recipient carina was used as a reference point; values obtained by LDV and RI were expressed as percentage of blood flow at the recipient carina. Two groups of animals were studied. In group 1 (n = 6) standard unilateral transplantation was performed; in group 2 (n = 6) a left bronchial artery was reimplanted into the descending thoracic aorta of the recipient. No differences were observed between the two groups with respect to preoperative or postoperative gas exchange or hemodynamics. In group 1, bronchial blood flow at the DC was 37.6 +/- 2.2% (LDV) and 44.1 +/- 14.8% (RI) of reference blood flow. At the DUC, blood flow was 54.9 +/- 7.7% (LDV) and 61.6 +/- 25.7% (RI) of normal flow. In group 2, blood flow was increased at the DC as measured by LDV (55.3 +/- 17.1%; p less than 0.05) and by RI (60.8 +/- 25.3%; p less than 0.2). A similar increase was found at the DUC (LDV: 81.8 +/- 19.3%; p less than 0.05; RI: 88.6 +/- 31.0%; p less than 0.2). It is concluded that there is a significant gradient of blood flow from intra- to extrapulmonary airways after lung transplantation. Reimplantation of a bronchial artery results in significant improvement of graft bronchial blood flow. Restoration of bronchial perfusion to normal levels, however, cannot be achieved, suggesting a possible defect in the microcirculation of the donor airways.

This article has been cited by other articles:

				K. Murai, H. Oizumi, T. Masaoka, T. Fujishima, M. Abiko, S. Shiono, and Y. Shimazaki Removal of cartilage rings of the graft and omentopexy for extended tracheal autotransplantation Ann. Thorac. Surg., March 1, 1999; 67(3): 776 - 780. [Abstract] [Full Text] [PDF]

				U. Herold, H. Jakob, M. Kamler, R. Thiele, U. Tochtermann, J. Weinmann, J. Motsch, M. M. Gebhard, and S. Hagl Interruption of bronchial circulation leads to a severe decrease in peribronchial oxygen tension in standard lung transplantation technique Eur. J. Cardiothorac. Surg., February 1, 1998; 13(2): 176 - 183. [Abstract] [Full Text] [PDF]

				M. A. Norgaard, P. S. Olsen, U. G. Svendsen, and G. Pettersson Revascularization of the Bronchial Arteries in Lung Transplantation: An Overview Ann. Thorac. Surg., October 1, 1996; 62(4): 1215 - 1221. [Abstract] [Full Text]