Journal
CURRENT OPINION IN ORGAN TRANSPLANTATION
Volume 20, Issue 5, Pages 506-514Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOT.0000000000000232
Keywords
acute lung injury; ischemia-reperfusion injury; lung transplantation; primary graft dysfunction
Categories
Funding
- National Institutes of Health [T32 HL-007891, K23 HL-121406]
- Actelion Entelligence Grant
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Purpose of review In 2005, the International Society for Heart and Lung Transplantation published a standardized definition of primary graft dysfunction (PGD), facilitating new knowledge on this form of acute lung injury that occurs within 72 h of lung transplantation. PGD continues to be associated with significant morbidity and mortality. This article will summarize the current literature on the epidemiology of PGD, pathogenesis, risk factors, and preventive and treatment strategies. Recent findings Since 2011, several manuscripts have been published that provide insight into the clinical risk factors and pathogenesis of PGD. In addition, several transplant centers have explored preventive and treatment strategies for PGD, including the use of extracorporeal strategies. More recently, results from several trials assessing the role of extracorporeal lung perfusion may allow for much-needed expansion of the donor pool, without raising PGD rates. Summary This article will highlight the current state of the science regarding PGD, focusing on recent advances, and set a framework for future preventive and treatment strategies.
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