Angiographic diagnosis of vascular complications in lung transplantation

Pulmonary angiography was performed following allotransplantation of the left lung in a series of 50 mongrel dogs. The examination was immediately followed by thoracotomy with inspection of the vascular anastomoses. Primary vascular complications of lung transplantation were present in four animals. In each case, the pulmonary angiogram successfully diagnosed the nature of the difficulty. The abnormalities consisted of thrombus obstructing the left atrial anastomosis, torsion of the graft pulmonary artery, occlusion of the pulmonary arterial anastomosis, and thrombus partially obstructing the arterial anastomosis. In 46 animals, intact vascular anastomoses were demonstrated by angiography. Adequacy of these anastomoses was confirmed by thoracotomy and by subsequent postmortem examination. Plain chest roentgenography and lung scanning will detect nonspecific dysfunction of the allografted lung, but angiography Is required to distinguish between rejection and primary vascular complications of lung transplantation.