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Apoptosis in Lung Transplantation

Shaf Keshavjee

Toronto General

Apoptosis or programmed cell death is currently an area of intense clinical and experimental interest. This process plays a significant role in tissue development and homeostasis. The number of diseases in which it is becoming evident that apoptosis plays a role as a causal or protective factor is rapidly increasing. The induction of cellular apoptosis presents an exciting potential therapeutic approach in the treatment of diseases such as cancer. In clinical and experimental transplantation, it appears that apoptosis aids in the removal of cells that are damaged during the overall process of transplantation because of acute injury or immunologic processes. In the transplanted lung, a significant amount of graft cells undergo apoptosis in the very early phase following graft reperfusion. This active and silent genetic shutdown of damaged cells relates to the length of ischemic preservation. The underlying molecular mechanisms of apoptosis induction in transplanted lungs remain to be discerned. In this review, we provide an overview of apoptosis with respect to its potential regulation in the setting of lung transplantation, particularly with respect to ischemia-reperfusion injury.

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				S. Fischer, M. de Perrot, M. Liu, A. A. MacLean, J. A. Cardella, Y. Imai, M. Suga, and S. Keshavjee Interleukin 10 gene transfection of donor lungs ameliorates posttransplant cell death by a switch from cellular necrosis to apoptosis J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1174 - 1180. [Abstract] [Full Text] [PDF]