Diagnosis and Reversal of Rejection in Experimental and Clinical Lung Allografts

Frank J. Veith, Spencer K. Koerner, Stanley S. Siegelman, Minoru Kawakami, Stewart Kaufman, Lari A. Attai, Jack W.C. Hagstrom, Marvin L. Gliedman

Research output: Contribution to journalArticle

Abstract

Experience in our patients and dogs with lung transplants has provided reliable criteria for diagnosing rejection and distinguishing it from other pathological processes such as pneumonia and ischemic injury. These criteria include fever; dyspnea; malaise; increased sputum production; decreased arterial oxygen tension; and, most importantly, the rapid development (often within hours) of a roentgenographic alveolar infiltrate without any change in the sputum bacteriology. Using these criteria we have identified multiple rejection episodes in 2 patients and in comparably immunosuppressed dogs. In almost every instance all acute manifestations of rejection, including the roentgenographic infiltrates, have been completely reversed by three to seven large intravenous doses of methylprednisolone given at 12- to 24-hour intervals. In the dogs, reversal of rejection has also been confirmed by gross and microscopical examination of the allograft. These findings show that acute rejection in lung allografts can be reliably identified by noninvasive criteria and successfully reversed.

Original languageEnglish (US)
Pages (from-to)172-183
Number of pages12
JournalAnnals of Thoracic Surgery
Volume16
Issue number2
DOIs
StatePublished - Jan 1 1973

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Veith, F. J., Koerner, S. K., Siegelman, S. S., Kawakami, M., Kaufman, S., Attai, L. A., Hagstrom, J. W. C., & Gliedman, M. L. (1973). Diagnosis and Reversal of Rejection in Experimental and Clinical Lung Allografts. Annals of Thoracic Surgery, 16(2), 172-183. https://doi.org/10.1016/S0003-4975(10)65834-1