Proliferative capacity of mononuclear cells in the human lung.

In pulmonary sarcoidosis, a chronic granulomatous disorder with different stages of activity, the proliferative capacity of the alveolar mononuclear cells is unknown. To get a closer look at this proliferation we combined pulse labeling (by means of tritium thymidine incorporation and autoradiography) with an immunocytochemical staining assay. This assay revealed on one single slide simultaneously blue CD4+ lymphocytes, brown CD8+ lymphocytes and red macrophages. We were able to show that CD4+ as well as CD8+ lymphocytes were radiolabeled only in the active state of the disease. But macrophage proliferation occurred independently of the activity of the disease. In other words with this combination of techniques, it is possible to differentiate, on a single slide, three subsets of mononuclear cells, in combination with their proliferative behavior.

[Allogenic lung transplantations following pretreatment of recipients with donor-specific splenic antigens]. / Allogene Lungentransplantationen nach Vorbehandlung der Rezipienten mit spenderspezifischem Milzantigen.

Lung transplantations were carried out in 20 not immunologically selected mongrel dogs which were pretreated with donor specific spleno-antigen mixture. The average survival time was double the size (12.3 days) as in a control group of untreated dogs after allogenic lung transplantation. A number of the receivers got Cyclophosphamid in addition to the spleno-antigen mixture. In this group the average survival time amounted to 17 days. A chronic course of the rejection was not to be achieved with this method. The autopsy showed thoracic infectious complications in nearly all receivers. A great number of central pulmonary vein thromboses in the transplant was discovered in this series in contrast to other lung transplantation series. Circumstances refer to a connection with hyperacute rejection courses. The receivers of this series survived the destruction of the transplant longer on an average as such in other experimental series.

[Results of studies on dogs after unilateral allogeneic lung transplantation without immunosuppression]. / Untersuchungsbefunde an Hunden nach unilateraler allogener Lungentransplantation ohne Immunsuppression.

The observations and the results after allogenic lung transplantation in 24 receivers were reported. The animals were not treated immuno-suppressively. They survived 6.2 days on an average and died in consequence of the rejection. The transplant is progressively threatened of bacterial infections after the beginning of the rejection even in case of an operation under sterile conditions. The investigations confirmed a narrow correlation between the leucocyte count and the course of the rejection. However, the condition of the transplant can be estimated approximately certainly by means of complex clinical methods of examination.

[Complications of experimental lung transplantations]. / Komplikationsmöglichkeiten experimenteller Lungentransplantationen.

Experimental lung transplantations are burdened with a very high rate of complications even is there is a strict consideration of sterile precautions. These complications occur predominantly directly in connection with organ rejection. Extrathoracic complications are rare and predominantly attributed to arterial embolism. All untreated receivers of lung had thoracic complications in autopsy. Only 5% of immune suppressively treated receivers were free of complications. Most frequent complications are pleuropulmonary infections. Weighty complications are haemorrhagic infarcts of the transplant and insufficiency of the bronchus. Only without complications can survived about years the chronic rejection.

[Experimental lung transplantation at the Research Institute for Lung Diseases and Tuberculosis Berlin-Buch. Technical standard and quality]. / Experimentelle Lungentransplantation im Forschungsinstitut für Lungenkrankheiten und Tuberkulose Berlin-Buch. Der technische Standard und seine Güte.

Report on the technical standard of unilateral orthotopic allogenic lung transplantation (allo- or homotransplantation) which has been developed and tried on animals since years at The Institute for Research on Pulmonary Diseases and Tuberculosis in Berlin-Buch. Technical insufficiencies which are crucial for essential alterations of the graft in autogenous lung transplantation (replantation) can not be excluded in allogenic transplantations also. By means of certain direct and indirect criteria the authors examined the development of quality of the technical standard between the years 1973 and 1976. Only based on optimal technique the results from examinations of recipient and graft can be correctly valued. On the other hand, optimal technique is an indispensable presupposition for optimal efficiency of several immunosuppressive methods. Duration of anesthesis, operation, ischemia of the transplantate, and of atrial, arterial, and bronchial anastomosis are considered for the assessment of the quality of technical standard. Thrombosis of pulmonary vein and of atrium was the most frequent complication in 71 allogenic pulmonary graftings. Their frequency decreased with improved technical skill, but some circumstances suggest that their formation is favored also by other factors. The duration of survival after unilateral allogenic lung transplantation is reported, although this is no direct scale for the technical performance.

[The thoracic radiographic picture in routine monitoring following unilateral allogenic lung transplantation in the dog]. / Das Thorax-Röntgenbild in der Routineüberwachung nach unilateraler allogener Lungentransplantation beim Hund.

Undesired effects of nonspecific immunosuppression may be delimited by individual dosage. Early recognition of allograft rejection is the presupposition for that steering. As long as immunologic test methods require a great expense of equipment, personnel, and time, and as other methods (bronchospirometry, lung puncture) after lung transplantation additionally endanger the recipient, clinical routine examinations are particularly important, primarly thorax x-ray examinations. The authors report on serial chest radiographs during the courses after 71 unilateral orthotopic allogenic pulmonary transplantations in dogs with regard to the findings at obduction. Possibilities of differential diagnosis shall be found by that, and the limits of interpreting x-ray films after lung transplantation shall be disclosed. Certain distinctive marks in the x-ray findings indicate the various possible complications; they can not be relied upon, however, when they only extend to the graft (hemorrhage, infection, rejection).