Report of the ISHLT Working Group on primary lung graft dysfunction Part IV: Prevention and treatment: A 2016 Consensus Group statement of the International Society for Heart and Lung Transplantation

Dysfunction of the pulmonary allograft with impaired oxygenation and radiographic opacities consistent with pulmonary edema occurs in up to 50% of lung transplant (LTx) recipients. 1 Christie J.D. Carby M. Bag R. et al. Report of the ISHLT Working Group on primary lung graft dysfunction part II: definition. A consensus statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2005; 24: 1454-1459 Abstract Full Text Full Text PDF PubMed Scopus (405) Google Scholar In 2005, 4 severity grades of primary graft dysfunction (PGD 0, 1, 2 and 3) were defined by a working group within the International Society for Heart and Lung Transplantation (ISHLT). 1 Christie J.D. Carby M. Bag R. et al. Report of the ISHLT Working Group on primary lung graft dysfunction part II: definition. A consensus statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2005; 24: 1454-1459 Abstract Full Text Full Text PDF PubMed Scopus (405) Google Scholar In most cases, the injury is mild and transient, but in 25% to 30% of cases it can result in severe hypoxemia with a partial pressure of oxygen/fraction of inspired oxygen ratio (PaO2/FIO2) of <200 mm Hg (PGD 3) within the first 72 hours (T0 to T72) after LTx. 2 Diamond J.M. Lee J.C. Kawut S.M. et al. Clinical risk factors for primary graft dysfunction after lung transplantation. Am J Respir Crit Care Med. 2013; 187: 527-534 Crossref PubMed Scopus (150) Google Scholar , 3 Shah R.J. Bellamy S.L. Localio A.R. et al. A panel of lung injury biomarkers enhances the definition of primary graft dysfunction (PGD) after lung transplantation. J Heart Lung Transplant. 2012; 31: 942-949 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar