Is Obliterative Bronchiolitis in Lung Transplantation Associated With Microvascular Damage to Small Airways? Heyman Luckraz, FRCS, Martin Goddard, FRCPath,

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Presentation transcript:

Is Obliterative Bronchiolitis in Lung Transplantation Associated With Microvascular Damage to Small Airways? Heyman Luckraz, FRCS, Martin Goddard, FRCPath, Keith McNeil, FRACP, Carl Atkinson, PhD, Linda D. Sharples, PhD, John Wallwork, FRCS The Annals of Thoracic Surgery Volume 82, Issue 4, Pages 1212-1218 (October 2006) DOI: 10.1016/j.athoracsur.2006.03.070 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Box and whisker plot illustrating the median and interquartile range of the number of blood vessels per unit length of airway circumference (BVPL) for the four groups. The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Bar chart showing the percentage of large blood vessel (LBV) per unit length of airway circumference for the four groups. The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Microvascular supply around non–obliterative bronchiolitis small airways in group A (ie, small airways with normal blood supply). von Willebrand factor (A) or CD31 (B) staining ×10 magnification . (E = epithelial layer; L = lumen; MV = microvascular supply to small airways [only few vessels indicated for photo clarity]; SM = smooth muscle layer.) The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Microvascular supply around small airways in group B (ie, small airways with not yet developed obliterative bronchiolitis but obliterative bronchiolitis seen in other small airways of same lung specimen). von Willebrand factor (A) and (B) staining ×20 magnification. (E = epithelial layer; L = lumen; MV = microvascular supply to small airways [note the lack of blood vessels around the small airways]; SM = smooth muscle layer.) The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Microvascular supply around small airways in group C (ie, small airways with partial obliterative bronchiolitis obliteration). von Willebrand factor staining ×10 magnification. (E = epithelial layer; L = lumen; MV = microvascular supply to small airways [note the abnormal blood vessels around the small airways]; SM = smooth muscle layer.) The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Microvascular supply around small airways in group D (ie, small airways with complete luminal obliterative bronchiolitis obliteration). von Willebrand factor and smooth muscle actin antibodies staining ×20 magnification. (BV = abnormal blood vessel within the obliterated lumen of the small airway; L & OB = small airway lumen completely obliterated by obliterative bronchiolitis scar; MV = microvascular supply to small airways [note the abnormal blood vessels around the small airways]; SM = smooth muscle layer.) The Annals of Thoracic Surgery 2006 82, 1212-1218DOI: (10.1016/j.athoracsur.2006.03.070) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions