444 
SURGERY AND TRANSPLANTATION 
I 
I 
With allografts an occasional animal will sur- 
vive more than 2 months with present immuno- 
suppression. Failure to achieve longer survivals 
with allografted lungs is an indication of im- 
perfections and/or toxicity of present immuno- 
suppression. Thus, the present work provides 
considerable support for the ultimate feasibility 
of single lung transplantation in patients with 
bilateral pulmonary disease. It also provides a 
laboratory model for studying the improved 
methods of immunosuppression that will be nec- 
essary to improve the poor ' results thus far 
achieved with therapeutic human lung allotrans- 
plantation. 
REFERENCES 
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and Ellis, F. H. Reimplantation of the dog lung 
with survival after contralateral pneumonectomy. 
Surg. Forum 15:173-175, 1964. 
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and Beattie, E. J. The immediate and long-term 
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the baboon living on only the reimplanted lung. 
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grafted and allografted lungs. Science 
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6. Veith, F. J., Richards, K., and Lalezaei, P. 
Protracted survival after homotransplantation of 
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8. Veith, F. J., Siegelman, S.S., and Dougherty, J. G. 
Long term survival after lung autotransplantation 
and immediate contralateral pulmonary artery liga- 
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VIN, G., Appaix, M., Courbil, J., Malmejac, C., 
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DISCUSSION 
Dr. Veith : I think we will pause at this 
point for questions and discussion. 
Gerald Moss, Rensselaer Polytechnic Insti- 
tute, Troy, New York : When you measured the 
resistance of that one lung before and after the 
transplant, was the left lung receiving less than 
50 per cent of the total cardiac output or was 
there temporary occlusion of the right pulmo- 
nary artery? 
Dr. Veith : We just measured main pulmo- 
nary arterial pressure and cardiac output and 
assumed 45 per cent of it was going to the left 
lung. 
Dr. Moss: You would expect with the total 
cardiac output going through that left lung nor- 
mally, the resistance would drop to approxi- 
mately half, which is a normal effect, because 
your pulmonary artery pressure shouldn't rise. 
Dr. - Veith : You're correct. I didn't put in 
the other obvious control — normal animals that 
undergo right pulmonary artery ligation. In es- 
sence, the left lung in the dog is smaller than 
the left lung in other experimental animals and 
in man, and when you measure pulmonary 
artery pressure after right pulmonary artery 
ligation in a normal dog, this is the approxi- 
mate range of the pressure change. In other 
words, after the operative procedures the ani- 
mal's total pulmonary vascular resistance goes 
up, which would be true in any animal sub- 
jected to anesthesia and thoracotomy. More im- 
portantly, the total pulmonary vascular resist- 
ance falls after the transplant, just as it would 
in a normal animal. 
