330 
SURGERY AND TRANSPLANTATION 
Figure 6. — Above. Degenerative changes in pulmonary nerve early following lung replantation. 
Facing page. Stable microscopic appearance of nerve two years after lung replantation. 
lymphatics, the vagus nerve and a combina- 
tion of these without actual division of the pul- 
monary artery, the pulmonary veins, or the 
main stem bronchus (Figure 7). Fifty-four 
adult mongrel dogs w^ere divided into eight 
groups of experimental and control animals.^^ 
The results indicated that the division of all 
hilar tissue — including nerves, lymphatics, 
bronchial arteries and hilar adventitial arteries 
— usually caused a significant decrease in 
oxygen uptake, which was also seen after de- 
nervation only. Edema often developed on the 
operated side, which undoubtedly reduced pul- 
monary function following hilar stripping. 
While the effect was not great, the loss of vagal 
innervation was found to impair capacity for 
both ventilation and oxygen uptake. Division 
of the bronchial arteries and the lymphatics 
had significant effect upon lung function. Thus, 
while it had been shown in other experiments 
that an intact pulmonary nerve supply was not 
absolutely essential for survival of the animal, 
there appeared to be little question that dener- 
vation did impair the functional capacity of 
the lung to a degree. 
Anatomical and Functional Growth of the 
Replanted Lung in Puppies 
Over the years a number of children vdth 
cystic fibrosis and severe pulmonary disability 
have been presented to us for possible lung 
transplantation, but these subjects with chronic 
pulmonary infection have not appeared to be 
suitable candidates for this procedure at the 
present stage of its development. Nevertheless, 
it seemed important to determine in the animal 
model whether or not a lung replanted in the 
