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

This Article Full Text 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 Author home page(s): Robert Fietsam, Jr. Gregory A. Thomas Larry W. Stephenson Frank A. Baciewicz, Jr. Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ruggiero, R. Articles by Baciewicz, F. A. Search for Related Content PubMed PubMed Citation Articles by Ruggiero, R. Articles by Baciewicz, F. A., Jr.

J Thorac Cardiovasc Surg 1994;108:253-258
© 1994 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

Detection of canine allograft lung rejection by pulmonary lymphoscintigraphy

Detroit, Mich., and Cleveland, Ohio

From the Divisions of Cardiothoracic Surgery ^a and Nuclear Medicine, ^b Wayne State University, School of Medicine, Detroit, Mich., and the Department of Pathology, ^c Cleveland Clinic Foundation, Cleveland, Ohio.

Address for reprints: Frank A. Baciewicz, Jr, MD, Harper Hospital, Suite 228, 3990 John R, Detroit, MI 48201.

Abstract

We previously demonstrated that lymphoscintigraphy could be used to study pulmonary lymphatic flow. Radiocolloids, high-molecular-weight proteins tagged with radioactive markers, are injected percutaneously in the periphery of the lung. These molecules enter the lymph, are transported via lymphatic channels, and concentrate in the tributary hilar and mediastinal lymph nodes, where they can be visualized by nuclear scan. The goal of this study was to determine whether pulmonary lymphoscintigraphy could be used to detect allograft rejection after lung transplantation. Thirteen mongrel dogs underwent left lung allotransplantation. Cyclosporine 15 mg/kg per day and azathioprine 1 mg/kg per day were given orally for postoperative immunosuppression. Lymphoscintigraphic studies were obtained 1 week after the operation and then at weekly intervals. In five dogs (group A), immunosuppression was continued until the animal died or was put to death 6 weeks later. Lymphoscintigraphy demonstrated reestablishment of lymphatic drainage between the lung graft and the mediastinum in all the animals 2 to 4 weeks after transplantation. In eight dogs (group B), immunosuppression was discontinued after reestablishment of graft lymphatic drainage was documented by two consecutive lymphoscintigraphic studies. The dogs continued to be studied with weekly scans. In group B, lymphatic drainage from the lung graft to the mediastinum disappeared 1 to 4 weeks after immunosuppression was stopped. Rejection was diagnosed clinically and confirmed histologically with open lung biopsies and/or autopsies in all animals. This study shows that canine allograft lung rejection is associated with disappearance of lymphatic drainage from lung graft to mediastinum, which can be documented by pulmonary lymphoscintigraphy, a minimally invasive technique that can be easily repeated. Pulmonary lymphoscintigraphy may be useful for early detection of lung allograft rejection. (J THORAC CARDIOVASC SURG 1994;108:253-8)

This article has been cited by other articles:

				H. J. Geissler, A. Dashkevich, U. M. Fischer, J. W.U. Fries, F. Kuhn-Regnier, K. Addicks, U. Mehlhorn, and W. Bloch First year changes of myocardial lymphatic endothelial markers in heart transplant recipients. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 767 - 771. [Abstract] [Full Text] [PDF]

				E. M. Marom, S. M. Palmer, J. J. Erasmus, J. E. Herndon, C. Zhang, and H. P. McAdams Pleural Effusions in Lung Transplant Recipients: Image-guided Small-Bore Catheter Drainage Radiology, July 1, 2003; 228(1): 241 - 245. [Abstract] [Full Text] [PDF]

				D. Shitrit, G. Izbicki, G. Fink, D. Bendayan, D. Aravot, M. Saute, and M. R. Kramer Late postoperative pleural effusion following lung transplantation: characteristics and clinical implications Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 494 - 496. [Abstract] [Full Text] [PDF]

				S. Kanno, P. C. Lee, S. J. Dodd, M. Williams, B. P. Griffith, and C. Ho A novel approach with magnetic resonance imaging used for the detection of lung allograft rejection J. Thorac. Cardiovasc. Surg., November 1, 2000; 120(5): 923 - 934. [Abstract] [Full Text] [PDF]

				F. G. Blankenberg, R. C. Robbins, J. H. Stoot, P. W. Vriens, G. J. Berry, J. F. Tait, and H. W. Strauss Radionuclide Imaging of Acute Lung Transplant Rejection With Annexin V Chest, March 1, 2000; 117(3): 834 - 840. [Abstract] [Full Text] [PDF]