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Updated: Nov 4, 2025

A Novel Approach to Monitoring Graft Neovascularization in the Human Gingiva
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Primary Graft Dysfunction.

Jake G Natalini1,2, Joshua M Diamond1

  • 1Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Seminars in Respiratory and Critical Care Medicine
|May 24, 2021
PubMed
Summary
This summary is machine-generated.

Primary graft dysfunction (PGD) is a severe lung injury after transplant. Ex vivo lung perfusion (EVLP) shows promise for PGD treatment and donor pool expansion without increasing PGD risk.

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Area of Science:

  • Transplantation immunology
  • Pulmonary medicine
  • Critical care medicine

Background:

  • Primary graft dysfunction (PGD) is a major cause of early morbidity and mortality after lung transplantation.
  • Severe PGD is linked to worse long-term outcomes and chronic lung allograft dysfunction.
  • Established risk factors include donor and recipient characteristics, and perioperative management.

Purpose of the Study:

  • To review the current understanding of PGD pathogenesis and risk factors.
  • To explore novel therapeutic targets and strategies for PGD prevention and treatment.
  • To highlight the role of ex vivo lung perfusion (EVLP) in PGD research and donor pool expansion.

Main Methods:

  • Literature review of primary graft dysfunction in lung transplantation.
  • Analysis of risk factors, pathogenesis, and therapeutic targets.
  • Evaluation of ex vivo lung perfusion (EVLP) as a platform for PGD research.

Main Results:

  • Multiple donor, recipient, and perioperative factors contribute to PGD development.
  • Several cellular pathways are implicated, offering potential therapeutic targets.
  • EVLP provides a safe platform for PGD research and has not increased PGD risk, even with extended ischemic times.

Conclusions:

  • PGD remains a critical challenge in lung transplantation with significant impact on patient outcomes.
  • Identifying and mitigating modifiable risk factors is crucial for PGD prevention.
  • EVLP represents a promising advancement for PGD treatment development and increasing lung availability.