eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
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SCImago Journal & Country Rank
2/2021
vol. 72
 
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abstract:
Original paper

Pulmonary vascular alterations in explanted lung after transplantation

Funda Demirag
1
,
Alkin Yazicioglu
2
,
Sinan Turkkan
2
,
Omac Tufekcioglu
3
,
Erdal Yekeler
2

1.
Department of Pathology, University of Health Sciences, Atatürk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey
2.
Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
3.
Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
Pol J Pathol 2021; 72 (2): 130-139
Online publish date: 2021/09/30
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Widespread pulmonary destruction and fibrosis can be seen in end-stage pulmonary diseases. This situation causes vascular remodeling of the pulmonary circulation and pulmonary hypertension. Lung transplantation is an alternative treatment for end-stage pulmonary diseases. The purpose of this study is to research pathological vascular alterations retrospectively in explanted lungs with or without pulmonary hypertension.

57 explanted lungs were evaluated for occlusive intimal fibroelastosis, smooth muscle proliferation, medial hypertrophy, intimal cellular or fibrous thickening, hemosiderosis, plexiform lesion, angiomatoid lesion, arteriosclerosis, venopathy, capillary duplication and arteriovenous malformation. Both systolic and mean pulmonary artery pressures were defined. The relationship between vascular patterns and pulmonary hypertension was investigated.

Pathological vascular alterations in explanted lungs with or without pulmonary hyper-

tension included medial hypertrophy (80.71%), intimal cellular or fibrous thickening (80.7%), arteriosclerosis (77.19%), smooth muscle proliferation (55.3%) and arteriovenous malformation (50.3%). Hemosiderosis (12.5%), plexiform lesion (14%) and venopathy (21%) were less frequent pathological vascular alterations. Capillary duplication was common in secondary pulmonary hypertension and was statistically meaningful.

Although medial hypertrophy and intimal thickness were seen in pulmonary hypertension, they can also be observed in end-stage pulmonary diseases without pulmonary hypertension. Interstitial capillary duplication was an important histopathological finding in end-stage lung diseases with pulmonary arterial hypertension.
keywords:

pulmonary hypertension, pulmonary remodeling, lung transplantation, vasculopathy, arteriovenous malformations

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