Primary graft dysfunction: lessons learned about the first 72 h after lung transplantation

Area of Science:

• Pulmonology
• Transplantation Medicine
• Critical Care

Background:

• Primary graft dysfunction (PGD) is a critical complication following lung transplantation, defined by the International Society for Heart and Lung Transplantation in 2005.
• PGD significantly contributes to morbidity and mortality in lung transplant recipients.
• Understanding PGD's epidemiology, pathogenesis, and risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To summarize the current literature on primary graft dysfunction (PGD) in lung transplantation.
• To review recent advances in understanding PGD's epidemiology, pathogenesis, and risk factors.
• To highlight current and future preventive and treatment strategies for PGD.

Main Methods:

• Literature review of published manuscripts since 2011.
• Analysis of clinical risk factors and pathogenesis of PGD.
• Evaluation of preventive and treatment strategies, including extracorporeal methods.

Main Results:

• Recent studies have elucidated clinical risk factors and pathogenesis of PGD.
• Various transplant centers are investigating preventive and treatment strategies, including extracorporeal approaches.
• Extracorporeal lung perfusion trials show promise for expanding the donor pool without increasing PGD rates.

Conclusions:

• The current state of science on PGD is evolving, with a focus on recent discoveries.
• Advances in understanding PGD pathogenesis and risk factors are facilitating new therapeutic avenues.
• Future research should continue to explore innovative strategies for PGD prevention and treatment, potentially expanding donor organ utilization.