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2015 ; 5
(4
): 739-43
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gab.com Text
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English Wikipedia
Pulmonary vascular changes 22 years after single lung transplantation for
pulmonary arterial hypertension: a case report with molecular and pathological
analysis
#MMPMID26697185
Zhao YD
; Peng J
; Granton E
; Lin K
; Lu C
; Wu L
; Machuca T
; Waddell TK
; Keshavjee S
; de Perrot M
Pulm Circ
2015[Dec]; 5
(4
): 739-43
PMID26697185
show ga
This study was undertaken to characterize the molecular and pathological
mechanisms of pulmonary vascular remodeling in a patient who developed chronic
lung allograft dysfunction and recurrent pulmonary hypertension (PH) 22 years
after undergoing a right single lung transplantation for pulmonary arterial
hypertension (PAH). Histopathologic examination of the explanted lungs at the
time of retransplantation showed characteristics of diffuse vascular remodeling
combined with features of acute and chronic thromboemboli and evidence of
bronchiolitis obliterans in the right lung allograft. In contrast, the native
left lung demonstrated pulmonary arterial changes in keeping with PAH associated
with disseminated pulmonary ossification. Real-time polymerase chain reaction and
Western blot-performed on the first lung allograft, the native lung, and the new
donor lung-demonstrated increased expression of apoptotic-related gene and
protein levels in the lung allograft compared with the native PAH lung and the
donor lung. Localization of cell apoptosis determined by triple immunostaining
for caspase 3, CD31, and smooth muscle actin was positive in the pulmonary
endothelial cells but not the smooth muscle cells of the lung allograft, while no
positive staining was detected for cell death in the native PAH lung. The
presence of PH in the lung allograft 22 years after transplantation was
associated with upregulation of apoptotic markers and evidence of apoptotic
endothelial cell death compared with the native lung and donor lung.