Cold ischemia–induced damage to vascular endothelium results in permeability alterations in transplanted lungs
| Autor: | M. A. Hidalgo, B. J. Fuller, C.J. Green, K.A. Shah |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Pulmonary and Respiratory Medicine
Pathology medicine.medical_specialty Adenosine Endothelium Allopurinol Organ Preservation Solutions Ischemia Bronchi Pulmonary Edema Vascular permeability Capillary Permeability Raffinose medicine Animals Insulin Apical cytoplasm Lung business.industry Organ Preservation Pulmonary edema medicine.disease Glutathione Rats Cold Temperature Transplantation medicine.anatomical_structure Rats Inbred Lew Reperfusion Injury Microscopy Electron Scanning Female Surgery Endothelium Vascular Cardiology and Cardiovascular Medicine business Reperfusion injury Lung Transplantation |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 112:1027-1035 |
| ISSN: | 0022-5223 |
| Popis: | Despite suggestions of a connection between endothelial damage and permeability alterations after ischemia and reperfusion in pulmonary tissue undergoing transplantation, no direct correlation between vascular endothelial discontinuity and parenchymal edema has yet been shown.Methods: Forty-two rat lungs were harvested and stored for 48 or 72 hours under hypothermic and ischemic conditions. Stored pulmonary tissue was studied before transplantation and 5 minutes or 24 hours after transplantation by light microscopy and scanning electron microscopy of arterial vascular endothelium.Results: Stored lungs not subjected to revascularization showed moderate perivascular edema, with small intercellular gaps in endothelial monolayers. Five minutes after transplantation, pulmonary tissue appeared congested, with perivascular and alveolar edema. Examination of vascular endothelium by scanning electron microscopy showed detachment of endothelial cells. Twenty-four hours after transplantation, edema, hemorrhage, and vascular congestion were found in all specimens. Arterial vascular endothelium showed weak intercellular connections, numerous intercellular gaps, and widespread cell detachment. Bronchial epithelial cells appeared damaged after storage, with loss of cilia, blebbing of apical cytoplasm, and cellular rounding. These changes were maintained 5 minutes after transplantation but appeared totally reversed after 24 hours in specimens stored 48 hours, whereas bronchial denudation was observed in 72-hour stored lungs. Statistically significant positive correlations (Kendall p < 0.001) between revascularization time and alveolar edema and hemorrhage were found for both storage periods.Conclusion: The results from this study demonstrate correlation between loss of endothelial monolayer continuity and histologic evidence of vascular permeability increases in pulmonary tissue before and after lung transplantation. (J THORAC CARDIOVASC SURG 1996;112:1027-35) |
| Databáze: | OpenAIRE |
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