JAMES D. HARDY 
337 
Figure 12.— The 12-a, 12-b and 12-c photographs demon- 
strate rather typical serial chest roentgenograms fol- 
lowing bilateral simultaneous lung replantation. Note 
maximal changes at 3 days, followed by progressive 
clearing. Figure 12-d presents a bilateral pulmonary 
arteriogram 4 months following bilateral lung re- 
plantation at the same operation. 
simultaneous bilateral lung allotransplantation 
model in dogs, to force the animal to survive 
completely on allotransplanted tissue. This com- 
pletely removes the nagging question of 
whether or not the allotransplanted tissue is 
furnishing significant respiratory support when 
one of the dog's own lungs remains in place. 
In the dog, the lung allograft is usually re- 
jected in approximately 5-7 days, if measures 
are not employed to minimize or suppress the 
rejection reaction (Figure 14). Actually, the 
reaction is so severe that the recipient usually 
dies in a few days. However, occasionally a dog 
will survive necrosis of the transplanted lung. 
this being due to the fact that the organ be- 
comes encased in a fibrous capsule and thus is 
sealed off from the general metabolic pool. 
Perhaps the earliest experiments at prolonga- 
tion of lung allograft survival were those of 
Hardin ^^'^^ and Neptune °° and their associates. 
Hardin's group found that a control group of 
lung homograft recipients survived for 12 days 
and that microscopic examination of the lung 
allotransplants suggested that the changes were 
due to tissue incompatibility. They achieved 
longer survival when the donors and recipients 
were litter mates. Cortisone therapy also ap- 
peared to increase the length of survival time. 
Neptune and co-workers performed 25 homolo- 
gous lung transplants and described the details 
of the usual clinical course and pathology. The 
average survival time without the use of ACTH 
was approximately 6 days, whereas ACTH in- 
jection in 4 animals resulted in an average 
survival time of 25 days. Blumenstock and as- 
PlGURE 12b. 
