Chest
Laboratory and Animal InvestigationsRadionuclide Imaging of Acute Lung Transplant Rejection With Annexin V
Section snippets
Rodent Model
Young adult male ACI (RT1a) and PVG (RT1c) Sprague-Dawley rats (Harlan; Indianapolis, IN), weighing between 200 and 250 g, underwent orthotopic left lung transplantation using the technique first described by Marck and Wildevuur.24 Animals were maintained at the animal care facilities of the Department of Cardiothoracic Surgery under standard temperature, humidity, and time-regulated light conditions. Water and food were provided ad libitum. Animals were treated in a humane manner, conforming
Histopathology and TUNEL Staining in Situ
The right and left (grafted) lungs of 18 transplanted animals were studied. None of the syngeneic (ACI to ACI) transplants (N = 7) demonstrated histologic evidence of rejection (ie, all were grade 0) or apoptotic nuclei as seen by in situ TUNEL staining (Table 1 ) for up to 7 days after surgery. The histology of all native lungs (N = 18) was also normal.
Ten of 11 allograft (PVG to ACI) transplants demonstrated grade 2 (moderate) or greater grades of acute rejection. The one allograft on day 3
Discussion
The frequency and severity of acute rejection episodes after lung transplantation, particularly in the first 4 months, is the most significant risk factor for the development of chronic rejection. Of particular concern to pulmonary transplant clinicians is that only 40% of the cases of histologically confirmed grades 2 through 4 acute rejection are associated with clinical signs or symptoms.1 However, noninvasive methods to diagnose acute rejection, including high-resolution CT and pulmonary
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Presented at the Scientific Session of the 29th Annual Fleischner Society Meeting Tucson, AZ, April 18, 1999.
Supported by National Institutes of Health grant 1RO1 HL61717-01A1 and HL-47151.