Background: In times of limited organs for transplantation, anti-HBc positive organs can be accepted for lung transplantation to increase the number of donors. Transplant recipients should be vaccinated against hepatitis B to prevent HBV infection. However, response after HBV vaccination has only been poorly evaluated in patients with end-stage pulmonary disease. Material/Methods: Anti-HBs titers of 40 anti-HBc negative patients with end-stage pulmonary disease evaluated for lung transplantation were analyzed with the Architect® system (Abbott, Germany). Responders, partial responders, or non-responders after HBV vaccination were defined by anti-HBs titers >100 IU/L, 10–100 IU/L, and <10 IU/L, respectively. Results: There were 34/40 individuals (85%) vaccinated against hepatitis B, and 6 were not vaccinated. Response, partial response, and non-response after vaccination were observed in 10/34 (29.4%), 11/34 (32.4%), and 13/34 (38.2%) of patients, respectively. Response to vaccination did not correlate with sex, pulmonary disease, comorbidities, immunosuppressive therapy, or smoking status. Conclusions: Although 85% of patients evaluated for lung transplantation were vaccinated against hepatitis B, 38.2% did not show an anti-HBs titer >10 IU/L. Thus, anti-HBs titers should be regularly monitored. Nonresponders should be considered for booster vaccinations, alternative vaccination schedules, or prophylactic treatment with a nucleos(t)ide analogue in case of transplantation of an anti-HBc–positive organ.

Background: In times of limited organs for transplantation, anti-HBc positive organs can be accepted for lung transplantation to increase the number of donors. Transplant recipients should be vaccinated against hepatitis B to prevent HBV infection. However, response after HBV vaccination has only been poorly evaluated in patients with end-stage pulmonary disease. Material/Methods: Anti-HBs titers of 40 anti-HBc negative patients with end-stage pulmonary disease evaluated for lung transplantation were analyzed with the Architect® system (Abbott, Germany). Responders, partial responders, or non-responders after HBV vaccination were defined by anti-HBs titers >100 IU/L, 10–100 IU/L, and <10 IU/L, respectively. Results: There were 34/40 individuals (85%) vaccinated against hepatitis B, and 6 were not vaccinated. Response, partial response, and non-response after vaccination were observed in 10/34 (29.4%), 11/34 (32.4%), and 13/34 (38.2%) of patients, respectively. Response to vaccination did not correlate with sex, pulmonary disease, comorbidities, immunosuppressive therapy, or smoking status. Conclusions: Although 85% of patients evaluated for lung transplantation were vaccinated against hepatitis B, 38.2% did not show an anti-HBs titer >10 IU/L. Thus, anti-HBs titers should be regularly monitored. Nonresponders should be considered for booster vaccinations, alternative vaccination schedules, or prophylactic treatment with a nucleos(t)ide analogue in case of transplantation of an anti-HBc–positive organ.

Σκοπός: Διεξάγαμε την παρούσα μελέτη για να καταδείξουμε την ύπαρξη των βρογχικο-στεφανιαίων αναστομώσεων στο πειραματικό μοντέλο του χοίρου. Επιπλέον διερευνήσαμε την επίπτωση της αρτηριοσκλήρυνσης στις βρογχικές αρτηρίες. Υλικό – Μέθοδος: Χρησιμοποιήθηκαν τα παρασκευάσματα καρδιάς και πνευμόνων από 6 χοίρους. Επιπλέον, δείγματα βρογχικών αρτηριών ελήφθησαν από 40 ασθενείς που υποβάλλονταν σε θωρακοτομή. Σημειώθηκαν αναλυτικά οι κλινικοί και εργαστηριακοί παράγοντες κινδύνου για ανάπτυξη αρτηριοσκλήρυνσης. Αποτελέσματα: Με υπολογιστική τομογραφία, ψηφιακή αγγειογραφία και χορήγηση χρωστικής ρητίνης καταδείξαμε το αναστομωτικό δίκτυο μεταξύ των βρογχικών και κυρίως των αριστερών στεφανιαίων αρτηριών σε 5 από τα 6 παρασκευάσματα. Η μικροσκοπική εξέταση των δειγμάτων δεν στοιχειοθέτησε ύπαρξη αθηροσκλήρυνσης, παρά μόνο ύπαρξη ασβεστοποιού σκλήρυνσης του μέσου χιτώνα σε ποσοστό 2.5%, που δεν συσχετίστηκε με τους παράγοντες κινδύνου αρτηριοσκλήρυνσης. Συμπεράσματα: Με δεδομένο ότι βρογχικές αρτηρίες παρουσιάζουν ελάχιστο βαθμό ασβεστοποιού σκλήρυνσης του μέσου χιτώνα., υποθέτουμε ότι θα μπορούσαν να συνδράμουν στη στεφανιαία κυκλοφορία μέσω των προαναφερθεισών αναστομώσεων σε καταστάσεις εκσεσημασμένης στεφανιαίας νόσου. Η μελέτη μας υπογραμμίζει την σπουδαιότητα των βρογχικών αρτηριών και των βρογχικο-στεφανιαίων αναστομώσεων σε περιπτώσεις εμβολισμού των βρογχικών αρτηριών, μεταμοσχεύσεων καρδιάς-πνευμόνων και αντιμετώπισης ανευρυσμάτων θωρακικής αορτής. / Aim of the study: We conducted this study to demonstrate the coronary-bronchial anastomotic routes in a porcine model. Additionally, we estimated the incidence of bronchial arteries arteriosclerosis. Material and Methods: Six heart-lung porcine blocks were used. Furthermore, 40 bronchial arteries were obtained from patients who underwent thoracotomy. Detailed clinical and laboratory atherosclerotic risk factors of the patients were documented. Results: Using CT-scan, Digital Subtraction Angiography and colored latex, we demonstrated communications between the bronchial and coronary circulation in 5 of 6 subjects. Histology revealed no established atherosclerotic lesion and narrowing of the lumen, but medial calcific sclerosis in 2.5%, that was independent from the arteriosclerotic risk factors. Conclusions: As evidence suggests that bronchial arteries only exhibit medial calcific sclerosis, we hypothesize that bronchial arteries can contribute to the coronary flow through the broncho-coronary anastomoses in cases of severe coronary artery disease. Our study emphasizes their importance and their anastomoses to coronaries in cases of embolization, heart-lung transplantation and thoracic aorta aneurysms repair.