Application of laser Doppler velocimetry to lung transplantation.

The relationship between healing of a bronchial anastomosis and regional blood flow was studied in adult mongrel dogs after allotransplantation of the left lung. Animals were divided into the following three groups according to the immunosuppressive regimen. Group A: no immunosuppressive treatment (n = 7); Group B: azathioprine (5 mg/kg/day) and prednisolone (2 mg/kg/day) (n = 4); Group C: cyclosporine (20 mg/kg/day) (n = 4). The mucosal blood flow was examined serially after transplantation with laser Doppler velocimetry (LDV) at the tracheal bifurcation of the recipient (1st LDV) and at the bifurcation of the upper lobe bronchus of the transplanted lung (2nd LDV). The LDV values were expressed as a ratio to the preoperative values at the same site. Healing of the bronchial anastomosis was also assessed macroscopically with a fiberoptic bronchoscope and microscopically. The 2nd LDV value of the animals in group A at 13 days after transplantation remained low (32.9 +/- 27.6%). The 2nd LDV value in group B, although not significantly different from group A, had recovered to the preoperative level by that time (93.7 +/- 23.4%). By contrast, the 2nd LDV value in group C remained significantly higher than that in group A (119.9 +/- 23.0%, P less than 0.05). The 1st and 2nd LDV values were reduced in animals having infection at the bronchial anastomosis, even those in groups B and C. Bronchial mucosal blood flow appeared to be affected by infection and rejection of the transplanted lung, and to correlate closely with the healing of the bronchial anastomosis. This LDV method is useful to evaluate bronchial mucosal blood flow in experimental, and possibly in clinical, fields.