328 
SURGERY AND TRANSPLANTATION 
clinically detectable leaks at the bronchial anas- 
tomosis. Late bronchial stricture develops oc- 
casionally. 
Regeneration of Lymphatic Channels in the 
Replanted and the Allotransplanted Lung 
As part of a systematic investigation of the 
causes of post-replantation pulmonary edema 
and diminished lung function, we investigated 
the rate of regeneration of the lung lymphatic 
channels in 15 adult mongrel dogs.^^ The 12 sur- 
vivors were variously evaluated at 24 and 48 
hours, 3, 7, 12 and 20 days, 6 and 7 weeks, and 1 
year after replantation. In brief, Sky-Blue Dye 
(1 to 2 cc's) was injected into the replanted lung 
tissue by the technique described by Weinberg. 
Spreading of the dye in the lung tissue was 
noted, and 25 to 45 minutes after its injection 
the animal was sacrified. The lungs were re- 
moved, carefully examined and photographed. 
Attempts to demonstrate the regenerating 
lymphatics with radiopaque materials failed 
because of the small size of these lymphatic 
channels. However, when the blue dye was in- 
jected into the replanted lung 24 hours after 
replantation, it spread towards the hilum and 
the peribronchial lymphatics within 45 minutes. 
The divided large and small lymphatic channels 
were clearly visible around the left main stem 
bronchus but did not cross the suture line 
(Figure 4). No dye was found in the peri- 
bronchial lymph nodes at this time. Likewise, 
even on the third day there was no evidence of 
migration of the dye across the suture line. 
The left main bronchus distal to the anastomosis 
did exhibit a blue color up to the suture line, 
but the proximal portion and the trachea re- 
mained unstained. In contrast, the dye injected 
into the lung of the dog re-operated upon one 
week later spread to the hilum. Although gross- 
Lymph nodes ' 
View of lymphatics 
24 hours after 
reimplantation 
(i 
''Ji I - 7 days 
ip.mjlj l l... J| i n. i ,^W M >..i . 1 
POSTERIOR 
FiGxmE 4. — Regeneration of lymphatics occurs readily in both replanted and allotransplanted lungs. 
