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Semin Respir Crit Care Med 2010; 31(2): 161-171
DOI: 10.1055/s-0030-1249111
© Thieme Medical Publishers

Primary Graft Dysfunction: Definition, Risk Factors, Short- and Long-Term Outcomes

James C. Lee1 , Jason D. Christie1 , 2 , Shaf Keshavjee3
  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 2Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
  • 3Division of Thoracic Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
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Publication History

Publication Date:
30 March 2010 (online)

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ABSTRACT

Primary graft dysfunction (PGD) is a form of early lung graft dysfunction that is a major cause of early morbidity and mortality following lung transplantation. Survivors of PGD have decreased long-term lung function and an increased risk of developing bronchiolitis obliterans syndrome (BOS), a manifestation of chronic graft dysfunction. This article reviews the current definition, contributing factors, and guidelines for grading clinical PGD, as well as controversies surrounding them. The current literature examining clinical risk factors for PGD is summarized, as are studies exploring molecular and biochemical markers for PGD prediction and severity. Studies examining the short- and long-term effects of PGD on lung transplant outcomes are reviewed. Lastly, we highlight the emerging concepts in lung transplantation that will potentially impact PGD incidence and outcomes.

KEYWORDS

Primary graft dysfunction - ischemia-reperfusion injury - lung transplantation

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James C LeeM.D. 

Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania School of Medicine

826 West Gates Bldg., 3400 Spruce St., Philadelphia, PA 19104

Email: james.lee@uphs.upenn.edu