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


RESULTS
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.


CONCLUSIONS
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.
aDepartment of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA bCenter for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Mary K
MK
Porteous
Joshua M
JM
Diamond
Jason D
JD
Christie
D055371:Acute Lung Injury / Q000276:immunology; D000818:Animals; D006801:Humans; D007113:Immunity, Innate; D016040:Lung Transplantation / Q000009:adverse effects*; D055031:Primary Graft Dysfunction / Q000276:immunology*; D012307:Risk Factors; D013997:Time Factors