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Pulmonary ischaemia–reperfusion injury: role of apoptosis

Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, Hong Kong, China

CORRESPONDENCE: C. S. H. Ng, Division of Cardiothoracic Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Sha Tin, NT, Hong Kong, China. Fax: 852 26377974. E-mail: cshng@netvigator.com

Keywords: Apoptosis, cardiopulmonary bypass, ischaemia–reperfusion, lung injury, necrosis, thoracic transplantation

Received: March 10, 2004
Accepted August 21, 2004

ABSTRACT

The central role of lung ischaemia–reperfusion injury in pulmonary dysfunction after cardiac surgery, particularly thoracic organ transplantation, has been well recognised.

Lung tissue necrosis after prolonged ischaemia is known to worsen lung function, which was believed to be due largely to adjacent tissue inflammation. Recent studies suggest that lung apoptosis following ischaemia–reperfusion could be equally important in the development of post-operative lung dysfunction.

The current literature on the mechanism and pathways involved in pulmonary dysfunction and, in particular, its relationship with apoptosis after lung ischaemia–reperfusion is briefly reviewed here.

A better understanding of lung apoptosis, as well as the upstream pathways, may help in the development of therapeutic strategies that could benefit patients undergoing cardiac and lung transplantation.