Long-term survival of dogs after experimental pulmonary reimplantation and staged contralateral pneumonectomy.

Sixteen dogs which survived left pulmonary reimplantation were subjected to staged contralateral pneumonectomy. Complete excision of the right lung was achieved in nine of these animals. There were three long-term survivors, of which two lived for more than three years on the single reimplanted lung. Stenosis of the pulmonary veins at the level of the atrial anastomosis was the commonest post-mortem finding. In the first week after reimplantation, the ventilation and oxygen uptake of the reimplanted lung invariably fell to low levels. These usually rose slowly but to a variable extent over the next six to eight weeks, after which there was little further improvement while the normal lung remained intact. In all three long-term survivors the ventilation and oxygen uptake of the reimplanted lung were more than doubled after contralateral pneumonectomy; the rise in oxygen uptake was less and occurred later than the rise in ventilation. Pulmonary hypertension and pulmonary oedema did not occur except in association with organic obstruction to the pulmonary venous drainage.