ABSTRACT
BACKGROUND: Due to the paucity of suitable donor organs for lung allotransplantation, a number of techniques have been developed to improve the lung preservation. Ultrastructural studies of the morphologic changes of the flushing, preservation and reperfusion injury in donor lungs have rarely been reported. METHODS: Adult dogs (n=46) were matched as donors and recipients for the single lung transplantation. The donor lungs were preserved after flushing with preservation solution and transplanted after 20-hours of preservation at 10degrees C. Ult rastructural features of the lung were examined after flushing, preservation and 2 hours after lung transplantation (reperfusion) respectively. RESULTS: Electron microscopy after flushing showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. The endothelial cells showed protrusion of tactile-like structure into the lumina, bleb or vacuole of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. Scanning electron microscopic examination of the pulmonary parenchyma showed focally alveolar collapse and focal consolidation after the preservation and more prominent changes after the reperfusion procedure. CONCLUSION: The ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage was occurred during the reperfusion. The reperfusion injury resulted in prominent pulmonary parenchymal alterations with a pattern of acute lung injury.
Subject(s)
Adult , Animals , Dogs , Humans , Acute Lung Injury , Blister , Cytoplasm , Endothelial Cells , Epithelial Cells , Fibrin , Flushing , Lung Transplantation , Lung , Macrophages, Alveolar , Microscopy, Electron , Phagocytosis , Reperfusion Injury , Reperfusion , Tissue Donors , VacuolesABSTRACT
BACKGROUND: Due to the paucity of suitable donor organs for lung allotransplantation, a number of techniques have been developed to improve the lung preservation. Ultrastructural studies of the morphologic changes of the flushing, preservation and reperfusion injury in donor lungs have rarely been reported. METHODS: Adult dogs (n=46) were matched as donors and recipients for the single lung transplantation. The donor lungs were preserved after flushing with preservation solution and transplanted after 20-hours of preservation at 10degrees C. Ult rastructural features of the lung were examined after flushing, preservation and 2 hours after lung transplantation (reperfusion) respectively. RESULTS: Electron microscopy after flushing showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. The endothelial cells showed protrusion of tactile-like structure into the lumina, bleb or vacuole of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. Scanning electron microscopic examination of the pulmonary parenchyma showed focally alveolar collapse and focal consolidation after the preservation and more prominent changes after the reperfusion procedure. CONCLUSION: The ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage was occurred during the reperfusion. The reperfusion injury resulted in prominent pulmonary parenchymal alterations with a pattern of acute lung injury.
Subject(s)
Adult , Animals , Dogs , Humans , Acute Lung Injury , Blister , Cytoplasm , Endothelial Cells , Epithelial Cells , Fibrin , Flushing , Lung Transplantation , Lung , Macrophages, Alveolar , Microscopy, Electron , Phagocytosis , Reperfusion Injury , Reperfusion , Tissue Donors , VacuolesABSTRACT
This study was undertaken to investigate the morphologic changes following flushing, preservation and reperfusion procedures in a canine lung allotransplantation model. Donor lungs were flushed with modified Euro-Collins (MEC) solution, low potassium dextran glucose (LPDG) solution or University of Wisconsin (UW) solution, then stored at 10oC for 20 hours. Light microscopic and electron microscopic features of the lungs were examined after flushing, preservation and 2 hours after reperfusion. After flushing light microscopy showed focal mild alveolar collapse and interstitial edema. After preservation the lung tissue showed multiple foci of alveolar collapse, consolidation, and alveolar epithelial cell damage. After reperfusion the lung tissue showed diffuse alveolar collapse, consolidation and many destroyed cellular debris in the alveolar lumina. After flushing electron microscopy showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. Some type I epithelial cells were detached from the basal lamina. The endothelial cells showed luminal protrusion of tactile-like structure and vacuoles of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. After preservation scanning electron microscopic examination of the pulmonary arteries showed multiple patchy areas of swelling or conglomerated lesions in the inner surface of the pulmonary arteries. In conclusion, the ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage occurred during the reperfusion.
Subject(s)
Humans , Basement Membrane , Cytoplasm , Dextrans , Edema , Endothelial Cells , Epithelial Cells , Fibrin , Flushing , Glucose , Lung Transplantation , Lung , Macrophages, Alveolar , Microscopy , Microscopy, Electron , Perfusion , Phagocytosis , Phenobarbital , Potassium , Pulmonary Artery , Reperfusion , Tissue Donors , Vacuoles , WisconsinABSTRACT
BACKGROUND: It is important to know one's own exact blood type. While the primary purpose of blood donation is an adequate blood supply, it is also an excellent opportunity for donors to confirm their blood type. Over 5% of the total population in Korea donated bloods in 1997. This study was carried out to investigate the relationship between increased participation in blood drives and an increase in members of the public's knowledge of their own blood type. METHODS: 271,346 blood donors at Dung-Bu Red Cross Blood Center answered to a questionnaire. The discrepancy ratio between perceived and actual ABO blood type was obtained through answerey questionnaire. Another 3,058 answered a more detailed questionnaire to probe their general knowledge of ABO and Rh(D) blood types were analyzed. RESLUTS: The discrepancy ratio between real and perceived ABO blood types was 1% but only 90.7% were confident of their ABO blood type. Only 58.3% were correctly answered to their Rh(D) blood type, and 98.7% of the donors who knew his or her Rh(D) blood type as negative were proved to be Rh(D) positive. The ABO discrepancy ratio was lower in females and it has decreased as blood donations increased (p<0.01). The discrepancy ratio increases with the age of the donor, and respondents over 30 had a higher discrepancy than those under 30 (p<0.01). Knowledge of Rh(D) blood type in transfusion was not well known to the general public. CONCLUSION: The study shows that the discrepancy ratio between real and perceived ABO blood type has decreased as a national blood donation rate has increased. Nevertheless, to increase the public's knowledge of blood type in relation to transfusion, especially to increase awareness of Rh(D) blood type, it is needed to conduct test exactly and to educate the result and general knowledge of blood type and tranfusion to the public.