Technical problems in lung allotransplantation. Causes of pulmonary venous outflow obstruction.

Abstract

Experience in this laboratory with approximately 100 canine and primate lung allotransplantation operations over the past 18 months has made clear the fact that technical problems are the cause of a large number of graft failures. In our series of 80 canine lung allotransplants which have been examined postmortem, more than 50% of failures appeared to be due to complete or partial obstruction to venous outflow from the graft. At least three distinct types of venous obstruction were encountered. The type of obstruction appears to be related to the duration of the posttransplant period, and may be characterized as acute, intermediate, and chronic venous outflow obstruction. Materials and Methods Eighty mongrel dogs, weighing from 15 to 26 kg (33 to 57 lb), were the recipients in this series. Another 80 were used as donors, each donor matched in weight with its respective recipient. With the exception of erythrocyte cross matching,