Current controversyPotential Refinements of The International Society for Heart And Lung Transplantation Primary Graft Dysfunction Grading System
Section snippets
ISHLT Primary Graft Dysfunction Grading System
The classification scheme is based on the 2 major clinical indicators Pao2/Fio2 ratio and chest X-ray infiltrates. Assessment is suggested at different time points (T) post-transplant, with T0 within 6 hours of final lung reperfusion; T24 at 24 hours; T48 at 48 hours, and T72 at 72 hours.9 A Pao2/Fio2 ratio exceeding 300 without infiltrates on chest X-ray is considered as grade 0. With infiltrates on chest X-ray, a Pao2/Fio2 ratio exceeding 300 is considered as grade 1, between 200 and 300 is
Conclusion
A standardized definition and grading system for PGD in lung transplantation is necessary to determine the incidence, associations, and potential causes of PGD, and allow data comparison between specific centers. The official ISHLT PGD grading system is simple and applicable to all lung transplant centers, and studies have shown its significant association with early and late post-transplant outcomes.
In this review, we have described advantages and disadvantages as well as nuances of the
References (19)
- et al.
Primary graft failure following lung transplantation: predictive factors of mortality
Chest
(2002) - et al.
Primary graft dysfunction and other selected complications of lung transplantation: a single-center experience of 983 patients
J Thorac Cardiovasc Surg
(2005) - et al.
Validation of the proposed International Society for Heart and Lung Transplantation grading system for primary graft dysfunction after lung transplantation
J Heart Lung Transplant
(2006) - et al.
Medium-term results of extracorporeal membrane oxygenation for severe acute lung injury after lung transplantation
J Heart Lung Transplant
(2004) - et al.
Extracorporeal membrane oxygenation after lung transplantation: Evolving technique improves outcomes
Ann Thorac Surg
(2004) - et al.
Report of the ISHLT working group on primary lung graft dysfunction part I: introduction and Methods
J Heart Lung Transplant
(2005) - et al.
Report of the ISHLT working group on primary lung graft dysfunction part II: DefinitionA consensus statement of the International Society for Heart and Lung Transplantation
J Heart Lung Transplant
(2005) - et al.
Report of the ISHLT working group on primary lung graft dysfunction part III: donor-related risk factors and markers
J Heart Lung Transplant
(2005) - et al.
Report of the ISHLT working group on primary lung graft dysfunction part IV: recipient-related risk factors and markers
J Heart Lung Transplant
(2005)