ISHLT special reportReport of the ISHLT Working Group on Primary Lung Graft Dysfunction Part V: Predictors and Outcomes
Section snippets
Short- and long-term outcomes of PGD
The recognition of outcomes of PGD is essential for determination of the impact of this early post-operative problem on short- and long-term prognosis. PGD remains responsible for significant early morbidity and mortality after lung transplantation.11 Relevant clinical outcomes of PGD include length of mechanical ventilation (LOV), ICU length of stay (LOS), hospital length of stay (hLOS), mortality, short- and long-term survival, cost, functional status and incidence of bronchiolitis obliterans
Predictors/scores of outcomes of PGD
Although there is more information on the prediction of development of PGD, there are limited data on the prediction of outcomes of PGD once it is present. Certain cellular, molecular, physiologic and clinical variables have been associated with outcomes in PGD in studies that typically included a small number of patients.
Fisher et al reported a significant association between high donor IL-8 concentration in bronchoalveolar lavage fluid and the development of early graft dysfunction and
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Cited by (102)
History of Lung Transplantation
2023, Clinics in Chest MedicineExtended post-ex vivo lung perfusion cold preservation predicts primary graft dysfunction and mortality: Results from a multicentric study
2020, Journal of Heart and Lung TransplantationCitation Excerpt :Among other factors, reperfusion injury due to PGD is a known consequence of prolonged ischemic time.25,26 This causes diffuse alveolar damage and correlates with acute rejection, CLAD, and overall mortality.5 Although the study failed to identify risk factors for prolonged post-EVLP CIT, these results should caution clinicians on the effect of prolonged ischemic times and advocate expeditious lung implantation after EVLP.
Elevated pre-transplant left ventricular end-diastolic pressure increases primary graft dysfunction risk in double lung transplant recipients
2019, Journal of Heart and Lung TransplantationPerioperative Management of the Lung Graft Following Lung Transplantation
2019, Critical Care Clinics67 - Pediatric Lung Transplantation
2019, Kendig's Disorders of the Respiratory Tract in ChildrenExtracorporeal Life Support in Lung Transplantation
2017, Clinics in Chest MedicineCitation Excerpt :ECMO may assist in the management of severe PGD by supporting gas exchange and pulmonary hemodynamics and by minimizing ventilator-associated lung injury in order to facilitate allograft recovery, much in the way ECMO has been used in reducing ventilator-associated lung injury in acute respiratory distress syndrome (ARDS).38–40 In a study comparing transplant recipients receiving ECMO for severe PGD with those without PGD or ECMO support, there was a significantly lower rate of graft survival for ECMO-supported severe PGD (30 days, 82% vs 97%; 3 years, 49% vs 74%; 5 years, 49% vs 61%; P = .001),41 albeit higher than has previously been reported for severe PGD.34,42,43 The same study reported significantly worse long-term allograft function in patients with ECMO-supported severe PGD (peak percentage-predicted forced expiratory volume in 1 second, 58% vs 83%; P = .006).41