! F. J. VEITH, S. B. P. SINHA, S. S. ! 
I' grossly. The lungs were inflated with 10 per 
j cent formalin instilled in the trachea at a pres- 
sure of 15 centimeters of water. They were then 
immersed in formalin, sectioned, and stained 
with hematoxylin and eosin. 
RESULTS 
Survival with Autografts 
Of the 16 dogs that underwent left lung auto- 
transplantation and right pulmonary artery li- 
gation, four died during the first postoperative 
week, one from a vascular thrombosis, one from 
pneumonia, and two of unknown causes. Three 
dogs lived from one to four weeks, and two of 
these dogs died of infarction and pneumonia in 
the right lung. The cause of death in the third 
dog was unknown. Two of the nine dogs which 
survived more than two months died during 
subsequent studies, one at four months and one 
at 14 months. Two others died of pneumonia or 
infarction of the right lung, or both, three and 
six months after operation. One old dog died of 
unknown causes 19 months after operation, and 
another animal died of unknown causes 30 
months after operation. The remaining three 
dogs have tolerated repeated studies and are 
alive and well with normal exercise tolerance 
and activity patterns, 33 to 45 months after 
operation. One pair of long-term survivors 
has produced two normal litters. 
Survival with Allografts 
Although the animals receiving lower dose 
immunosuppression (group 1) appeared to fare 
better, there was no significant difference in 
survival between the various groups of immu- 
JELMAN AND J. W. C. HAGSTROM 439 
nosuppressed animals receiving left lung allo- 
grafts with right pulmonary artery ligation 
(Table I) . Therefore, the fate of all 115 animals 
can best be described as a single group. Eleven 
(10%) of the animals lived more than one 
month; six (5%) lived more than two months; 
but only one survived over three months. Al- 
though 16 of the 104 deaths within one month 
of operation were the result of technical prob- 
lems such as atrial thrombosis or bronchial de- 
hiscence with leakage, many more (52) were 
due to a combination of pneumonia and allo- 
graft rejection involving the transplanted lung. 
Fifteen animals died with an essentially normal 
transplant but with severe pneumonia and/or 
infarction of their own right lung. Twenty-one 
of the deaths within one month of operation 
were not associated with any significant morph- 
ologic abnormality in either lung. Toxicity of 
the immunosuppressive therapy may have con- 
tributed to the death of these animals. 
Six of the animals surviving more than one 
month died because of the effects of chronic al- 
lograft rejection on the transplant. One animal 
died from pneumonia and/or infarction of his 
right lung. However, four animals had no satis- 
factory morphologic cause of death either in 
their lungs or other organs. These latter four 
animals had lungs that were histologically nor- 
mal in most areas except for slight mononuclear 
cell infiltration of their allograft (Figure 1). 
Hemodynamic and Blo;;d Gas Studies 
Pulmonary artery mean pressure increased 
significantly with the approximate doubling of 
blood flow through the left lung brought about 
by ligation of the right pulmonary artery 
(Table II). However, this increase was not di- 
Table II. — Hemodynamic and Blood Gas Data After Autotramplantation of the left Lung and Right Pulmonary 
artery ligation 
Pulmonary 
Left Lung 
Arterial 
Venous 
No. 
artery 
Vascular 
Arterial 
Arterial 
Oxygen 
Oxygen 
of 
pressure 
resistance 
Pft! 
PC02 
Arterial 
Saturation 
Saturation 
dogs 
(mm Hg) 
(dynes sec/cm^) 
(mm Hg) 
(mm Hg) 
PH 
(per cent) 
(per cent) 
Preoperative 
16 
IB ± 1 
865 ± 92 
80 ± 4 
34 ± 4 
7.41 ± .03 
95 ± 1 
81 ± 1 
1 hr postoperative 
16 
24 ± 3 
831 ± 72 
83 ± 5 
26 ± 2 
7.40 ± .02 
95 ± 1 
80 ± 1 
1-12 days postoperative 
4* 
81 ± 6 
27 ± 1 
7.45 ± .01 
95 ± 1 
76 ± 5 
2-4 mos. postoperative 
9* 
24 ± 1 
610 ± 76 
72 ± 4 
39 ± 8 
7.39 ± .03 
94 ± 2 
78 ± 5 
4-24 mos. postoperative 
7« 
25 ± 2 
757 ± 69 
82 ± 6 
37 ± 4 
7.40 ± .02 
95 ± 2 
78 ± 6 
24-44 mos. postoperative 
3« 
74 ± 6 
36 ± 4 
7.38 ± .02 
94 ± 2 
80 ± 2 
Values are expressed as means ± standard error of determinations made while dogs were ventilated with room air. 
• Most dogs were studied on more than one occasion. 
