help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by WARE, L. B.
Right arrow Articles by MATTHAY, M. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by WARE, L. B.
Right arrow Articles by MATTHAY, M. A.

Am. J. Respir. Crit. Care Med., Volume 159, Number 3, March 1999, 980-988

Alveolar Epithelial Fluid Transport Capacity in Reperfusion Lung Injury after Lung Transplantation

LORRAINE B. WARE, JEFFREY A. GOLDEN, WALTER E. FINKBEINER, and MICHAEL A. MATTHAY

Cardiovascular Research Institute, Division of Pulmonary and Critical Care, Departments of Medicine, Pathology, and the Heart Lung Transplantation Program, University of California, San Francisco, California

Reperfusion lung injury is an important cause of morbidity and mortality after orthotopic lung transplantation. The purpose of this study was to investigate the function of the alveolar epithelium in the setting of reperfusion lung injury. Simultaneous samples of pulmonary edema fluid and plasma were collected from eight patients with severe post-transplantation reperfusion edema. The edema fluid to plasma protein ratio was measured, an indicator of alveolar-capillary barrier permeability. The initial edema fluid to plasma protein ratio was > 0.75 in six of eight patients, confirming the presence of increased permeability of the alveolar-capillary barrier. Graft ischemic time was positively correlated with the degree of permeability (r = 0.77, p < 0.05). In four of six patients with serial samples, there was a high rate of alveolar fluid clearance (19 ± 9%/h, mean ± SD). Alveolar fluid clearance was calculated from serial samples in six patients. Intact alveolar fluid clearance correlated with less histologic injury, rapid resolution of hypoxemia, and more rapid resolution of radiographic infiltrates. The two patients with no net alveolar fluid clearance had persistent hypoxemia and more severe histologic injury. This study provides the first direct evidence that increased permeability to protein is the usual cause of reperfusion edema after lung transplantation, with longer ischemic times associated with greater permeability to protein in the transplanted lung. The high rates of alveolar fluid clearance indicate that the fluid transport capacity of the alveolar epithelium may be well preserved in the allograft despite reperfusion lung injury. The ability to reabsorb fluid from the alveolar space was a marker of less severe reperfusion injury, whereas the degree of alveolar-capillary barrier permeability to protein was not. Measurement of alveolar fluid clearance may be useful to assess the severity of reperfusion lung injury and to predict outcome when pulmonary edema develops after lung transplantation.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
R. V. Venkateswaran, V. B. Patchell, I. C. Wilson, J. G. Mascaro, R. D. Thompson, D. W. Quinn, R. A. Stockley, J. H. Coote, and R. S. Bonser
Early Donor Management Increases the Retrieval Rate of Lungs for Transplantation
Ann. Thorac. Surg., January 1, 2008; 85(1): 278 - 286.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Cell Mol. Bio.Home page
I. C. Davis, E. R. Lazarowski, F.-P. Chen, J. M. Hickman-Davis, W. M. Sullender, and S. Matalon
Post-Infection A77-1726 Blocks Pathophysiologic Sequelae of Respiratory Syncytial Virus Infection
Am. J. Respir. Cell Mol. Biol., October 1, 2007; 37(4): 379 - 386.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
J. A. Frank, R. Briot, J. W. Lee, A. Ishizaka, T. Uchida, and M. A. Matthay
Physiological and biochemical markers of alveolar epithelial barrier dysfunction in perfused human lungs
Am J Physiol Lung Cell Mol Physiol, July 1, 2007; 293(1): L52 - L59.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. D. Fremont, R. H. Kallet, M. A. Matthay, and L. B. Ware
Postobstructive Pulmonary Edema: A Case for Hydrostatic Mechanisms
Chest, June 1, 2007; 131(6): 1742 - 1746.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
S. U. Sixt, M. Beiderlinden, H. P. Jennissen, and J. Peters
Extracellular proteasome in the human alveolar space: a new housekeeping enzyme?
Am J Physiol Lung Cell Mol Physiol, May 1, 2007; 292(5): L1280 - L1288.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Cell Mol. Bio.Home page
H. G. Folkesson and M. A. Matthay
Alveolar Epithelial Ion and Fluid Transport: Recent Progress
Am. J. Respir. Cell Mol. Biol., July 1, 2006; 35(1): 10 - 19.
[Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
H. G. Folkesson, C. J. Chapin, L. L. Beard, R. Ertsey, M. A. Matthay, and J. A. Kitterman
Congenital diaphragmatic hernia prevents absorption of distal air space fluid in late-gestation rat fetuses
Am J Physiol Lung Cell Mol Physiol, March 1, 2006; 290(3): L478 - L484.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
G. M. Mutlu and J. I. Sznajder
Mechanisms of pulmonary edema clearance
Am J Physiol Lung Cell Mol Physiol, November 1, 2005; 289(5): L685 - L695.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
M. A. Matthay, L. Robriquet, and X. Fang
Alveolar Epithelium: Role in Lung Fluid Balance and Acute Lung Injury
Proceedings of the ATS, October 1, 2005; 2(3): 206 - 213.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D.V. Pilcher, C.D. Scheinkestel, G.I. Snell, A. Davey-Quinn, M.J. Bailey, and T.J. Williams
High central venous pressure is associated with prolonged mechanical ventilation and increased mortality after lung transplantation
J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 912 - 918.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Lung Cell. Mol. Physiol.Home page
M. Hu, X. Lin, Q. Du, E. J. Miller, P. Wang, and H. H. Simms
Regulation of polymorphonuclear leukocyte apoptosis: role of lung endothelium-epithelium bilayer transmigration
Am J Physiol Lung Cell Mol Physiol, February 1, 2005; 288(2): L266 - L274.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. B. Ware
Modulation of Alveolar Fluid Clearance by Acute Inflammation: The Plot Thickens
Am. J. Respir. Crit. Care Med., February 1, 2004; 169(3): 332 - 333.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. Sugita, P. Ferraro, A. Dagenais, M.-E. Clermont, P. Barbry, R. P. Michel, and Y. Berthiaume
Alveolar Liquid Clearance and Sodium Channel Expression Are Decreased in Transplanted Canine Lungs
Am. J. Respir. Crit. Care Med., May 15, 2003; 167(10): 1440 - 1450.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. de Perrot, M. Liu, T. K. Waddell, and S. Keshavjee
Ischemia-Reperfusion-induced Lung Injury
Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 490 - 511.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
Y. Berthiaume, H. G. Folkesson, and M. A. Matthay
Lung Edema Clearance: 20 Years of Progress: Invited Review: Alveolar edema fluid clearance in the injured lung
J Appl Physiol, December 1, 2002; 93(6): 2207 - 2213.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
C. Sartori and M.A. Matthay
Alveolar epithelial fluid transport in acute lung injury: new insights
Eur. Respir. J., November 1, 2002; 20(5): 1299 - 1313.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
L. B. Ware, X. Fang, Y. Wang, T. Sakuma, T. S. Hall, and M. A. Matthay
Lung Edema Clearance: 20 Years of Progress: Selected Contribution: Mechanisms that may stimulate the resolution of alveolar edema in the transplanted human lung
J Appl Physiol, November 1, 2002; 93(5): 1869 - 1874.
[Abstract] [Full Text] [PDF]

Home page
 Physiol. Rev.Home page
M. A. Matthay, H. G. Folkesson, and C. Clerici
Lung Epithelial Fluid Transport and the Resolution of Pulmonary Edema
Physiol Rev, July 1, 2002; 82(3): 569 - 600.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. G. Duarte and S. Lick
Predicting Outcome in Primary Graft Failure
Chest, June 1, 2002; 121(6): 1736 - 1738.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
K. NOWAK, M. KAMLER, M. BOCK, J. MOTSCH, S. HAGL, H. JAKOB, and M.-M. GEBHARD
Bronchial Artery Revascularization Affects Graft Recovery after Lung Transplantation
Am. J. Respir. Crit. Care Med., January 15, 2002; 165(2): 216 - 220.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. S. Chesnutt, T. J. Nuckton, J. Golden, H. G. Folkesson, and M. A. Matthay
Rapid Alveolar Epithelial Fluid Clearance Following Lung Lavage in Pulmonary Alveolar Proteinosis
Chest, July 1, 2001; 120(1): 271 - 274.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. B. WARE and M. A. MATTHAY
Alveolar Fluid Clearance Is Impaired in the Majority of Patients with Acute Lung Injury and the Acute Respiratory Distress Syndrome
Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1376 - 1383.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. D. CRANDALL and M. A. MATTHAY
Alveolar Epithelial Transport . Basic Science to Clinical Medicine
Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 1021 - 1029.
[Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. FISCHER, A. A. MACLEAN, M. LIU, J. A. CARDELLA, A. S. SLUTSKY, M. SUGA, J. F. M. MOREIRA, and S. KESHAVJEE
Dynamic Changes in Apoptotic and Necrotic Cell Death Correlate with Severity of Ischemia-Reperfusion Injury in Lung Transplantation
Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1932 - 1939.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
R. C. King, O. A.R. Binns, F. Rodriguez, R. C. Kanithanon, T. M. Daniel, W. D. Spotnitz, C. G. Tribble, and I. L. Kron
Reperfusion injury significantly impacts clinical outcome after pulmonary transplantation
Ann. Thorac. Surg., June 1, 2000; 69(6): 1681 - 1685.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
V. G. Nielsen, M. S. Baird, B. T. Geary, and S. Matalon
Halothane Does Not Decrease Amiloride-Sensitive Alveolar Fluid Clearance in Rabbits
Anesth. Analg., June 1, 2000; 90(6): 1445 - 1449.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
L. B. Ware and M. A. Matthay
The Acute Respiratory Distress Syndrome
N. Engl. J. Med., May 4, 2000; 342(18): 1334 - 1349.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1999 American Thoracic Society