Reestablishment of lymphatic drainage after canine lung transplantation

Ruggiero, Renato; Muz, Jaroslaw; Fietsam, Robert; Thomas, Gregory A.; Welsh, Robert J.; Miller, James E.; Stephenson, Larry W.; Baciewicz, Frank A.

doi:10.1016/s0022-5223(19)33753-5

Cited by 39 publications

(19 citation statements)

References 6 publications

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“…Under normal physiological conditions, lymphatics facilitate the trafficking of antigen presenting cells to draining lymph nodes to elicit acquired immune responses. Donor lymphatic vessels reconnect to those of the recipient 2-4 weeks after transplantation (1). This period when donor lymphatic vessels are disconnected coincides with the priming of the alloimmune response.…”

Section: Introductionmentioning

confidence: 96%

SPECT/CT Lymphoscintigraphy of Heterotopic Cardiac Grafts Reveals Novel Sites of Lymphatic Drainage and T Cell Priming

Brown

Badar

Sunassee

et al. 2011

American Journal of Transplantation

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The normal function of lymphatic vessels is to facilitate the trafficking of antigen presenting cells to draining lymph nodes where they evoke an immune response. Donor lymphatic vessels are not connected to that of recipients' during organ transplantation. The pathophysiology of this disruption has received little attention. Murine heterotopic cardiac transplantation has been used extensively in transplantation research. Following vascularized organ transplantation, the main site of allosensitization is thought to be in the spleen of the recipient as a result of migration of donor passenger leukocytes via blood. Here, using Single Photon Emission Computed Tomography/Computerized Tomography (SPECT/CT) lymphoscintigraphy, we studied the pattern of lymphatic flow from mouse heterotopic abdominal cardiac grafts and identified mediastinal lymph nodes as the draining nodes for the donor graft. Staining with HY tetramer after transplantation of HY mismatched heart grafts and ELISPOT following allogeneic grafts to detect donor specific T cells revealed them as important sites for allosensitization. Our data indicates that mediastinal lymph nodes play a crucial role in the alloimmune response in this model, and should be used for ex vivo and adoptive transfer studies after transplantation in addition to the spleen.

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Section: Introductionmentioning

confidence: 96%

SPECT/CT Lymphoscintigraphy of Heterotopic Cardiac Grafts Reveals Novel Sites of Lymphatic Drainage and T Cell Priming

Brown

Badar

Sunassee

et al. 2011

American Journal of Transplantation

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“…Therefore, it has been suggested that inhibiting lymphangiogenesis could be critical for graft tolerance and survival (20,21). However, lung allografts are acutely rejected within 7 days after transplantation in animal transplant models (22)(23)(24)(25), whereas spontaneous restoration of lymphatic drainage from the transplanted lung to the lymph nodes occurs no earlier than day 7 after transplantation (26,27). Since the onset of lung rejection precedes the reestablishment of lymphatic continuity, it is possible that insufficient lymphatic drainage could be responsible, at least in part, for acute lung allograft rejection.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic lymphangiogenesis ameliorates established acute lung allograft rejection

Cui¹,

Liu²,

Monzon-Medina³

et al. 2015

Journal of Clinical Investigation

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Lung transplantation is the only viable option for patients suffering from otherwise incurable end-stage pulmonary diseases such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis. Despite aggressive immunosuppression, acute rejection of the lung allograft occurs in over half of transplant recipients, and the factors that promote lung acceptance are poorly understood. The contribution of lymphatic vessels to transplant pathophysiology remains controversial, and data that directly address the exact roles of lymphatic vessels in lung allograft function and survival are limited. Here, we have shown that there is a marked decline in the density of lymphatic vessels, accompanied by accumulation of low-MW hyaluronan (HA) in mouse orthotopic allografts undergoing rejection. We found that stimulation of lymphangiogenesis with VEGF-C156S, a mutant form of VEGF-C with selective VEGFR-3 binding, alleviates an established rejection response and improves clearance of HA from the lung allograft. Longitudinal analysis of transbronchial biopsies from human lung transplant recipients demonstrated an association between resolution of acute lung rejection and decreased HA in the graft tissue. Taken together, these results indicate that lymphatic vessel formation after lung transplantation mediates HA drainage and suggest that treatments to stimulate lymphangiogenesis have promise for improving graft outcomes.

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“…Lymphatic drainage of the transplanted lung is interrupted and this increases the likelihood of pulmonary edema so that careful management of fluid balance is imperative. The reformation of lymphatic channels does occur but the extent and timing is unclear at this time (16,17).…”

Section: Discussionmentioning

confidence: 99%

A non‐thoracic operation for a patient with single lung transplantation

Haddow

Brock‐Utne

1999

Acta Anaesthesiol Scand

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The number of lung transplants performed annually is increasing. It is becoming more likely that these patients will present post transplantation to anesthesiologists who have little experience in dealing with the physiological, pharmacological, medical and surgical problems that these patients present. This article discusses the management of a patient presenting for surgery after lung transplantation.

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Reestablishment of lymphatic drainage after canine lung transplantation

Cited by 39 publications

References 6 publications

SPECT/CT Lymphoscintigraphy of Heterotopic Cardiac Grafts Reveals Novel Sites of Lymphatic Drainage and T Cell Priming

SPECT/CT Lymphoscintigraphy of Heterotopic Cardiac Grafts Reveals Novel Sites of Lymphatic Drainage and T Cell Priming

Therapeutic lymphangiogenesis ameliorates established acute lung allograft rejection

A non‐thoracic operation for a patient with single lung transplantation

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