The combination of FU/l-LV produced response rates, response durations, and survival times similar to those with FU/d,l-LV. Biochemical modulation of FU by either pure l-LV or racemic LV thus appears to result in equivalent clinical efficacy.

No abstract

Experimental emphysema was induced by multiple intratracheal instillation of Papain in a dose of 2 mg/kg body weight in 4 bastard dogs. Development of emphysema was objectivated by pulmonary function tests. Increase of static lung compliance, decrease of lung elastance, and increase of air-way resistance were observed. In addition arterial pO2 decreased while pCO2 remained constant. Following single lung homotransplantation there was an increase of respiratory rate and minute ventilation, the transpulmonary pressure rose in the first postoperative days, static lung compliance was diminished. Four weeks after transplantation typical functional changes of emphysema could be demonstrated concerning the slope and appearance of the compliance loops. Arterial pO2 however remained within the normal range. This functional behaviour does not support the concept of a ventialtion perfusion imbalance after lung transplantation in emphysema patients. Respiratory insufficiency therefore is probably caused by an alveolar type of rejection.

A method to eluat donororganspecific antibodies enabling direct and specific access to the pattern of humoral rejection after lung allotransplantation is demonstrated. The antibodies were evaluated quantitatively and qualitatively by elution of lung-grafts immunoglobulins and by a consequent investigation of the eluates using the passive haemagglutination- and indirect immunflourescence- test against donors' lung-antigen. Humoral antidonorlung-antibodies could be proved in all rejected grafts belonging to sensitized as well as to unsensitized recipients. There can be seen a highly significant correlation when comparing the results of the passive haemagglutination and indirect immunfluorescence test (r = 0,93, p less than or equal 0,01). On the other hand negative results of the investigations of eluates by lungantigens of other dogs show the specifity of humoral graft rejection. The suprising fact that there does not exist an essential difference between the results of sensitized and nonsensitized animals reveals a humoral immunresponse in hyperacute as well as in acute rejection.

ZusammenfassungDie Hämodynamik nach Lungentransplantation wurde an 20 Tieren unter Zuhilfenahme der akuten und der chronischen elektromagnetischen Strömungsmeßtechnik mit und ohne immunsuppressiver Therapie untersucht.Es fand sich neben der typischen Abstoßungsreaktion, wie sie bei anderen Organen bekannt ist, eine "alveoläre" Manifestation der Abstoßung, die bei nahezu ungestörter Perfusion durch Ventilationseinschränkung zu Störung des Perfusions-Ventilations-Verhältnisses und zu respiratorischer Insuffizienz führt.Die atemphysiologische Beurteilung eines Lungenhomotransplantates 16 Monate postoperativ ergab eine Zweidrittelfunktion des Transplantates gegenüber der Eigenlunge. Results Following Canine Pulmonary TransplantationThe hemodynamic following pulmonary transplantation has been investigated in 20 dogs using acute and chronic electromagnetic flowmeter technique.Besides the typical rejection phenomena as in other organs an alveolar manifestation of rejection of the lung -accompanied by near normal perfusion, but decrease in ventilation -was noted, resulting in a perfusion ventilation inbalance and respiratory insufficiency.16 months postoperatively a two third function of the transplant compared to the own lung of a long-time surviver could be demonstrated.Bei über 30 bisher klinisch durchgeführten Lungentransplantationen waren die unbefriedigenden Ergebnisse auf eine unzureichende Funktion des Transplantates zurückzuführen. Als Hauptursache wurde in den meisten Fällen eine schwere Störung des Ventilations-Perfusions-Verhältnisses gefunden. Veith hat eine derartige Störung des Ventilations-Perfusions-Verhältnisses nach Lungentransplantation durch die Anwesenheit einer erkrankten Lunge -wie dies in der klinischen Situation der Fall ist -negiert und diesen Umstand in seinen tierexperimentellen Untersuchungen an Hunden mit Lungenemphysem bewiesen.Heruntergeladen von: National University of Singapore. Urheberrechtlich geschützt.