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Semin Respir Crit Care Med 2006; 27(5): 501-507
DOI: 10.1055/s-2006-954608
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Primary Graft Dysfunction in Lung Transplantation

Yvonne Marie Carter1 , R. Duane Davis1
  • 1Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center, Durham, North Carolina
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Publication History

Publication Date:
26 October 2006 (online)

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ABSTRACT

Following the initial successful lung transplants reported by the Toronto Lung Transplant Group in 1986, lung transplantation has evolved into an effective treatment of isolated pulmonary failure and has been performed in more than 20,000 recipients. Increased experience, adjustments, and additions to the surgical technique and improved perioperative care have combined to decrease morbidity and improve survival in lung transplant recipients. An area in which improvements have been made but that continues to cause major morbidity, mortality, and impact on long-term allograft function is primary allograft dysfunction, which occurs in 11 to 60% transplant patients, depending on the diagnostic criteria applied. The basis of this potentially devastating complication is likely ischemia reperfusion injury of the donor allograft with activation of recipient innate immunity. This article discusses mechanisms of primary graft dysfunction in light of recent International Society for Heart and Lung Transplantation consensus definitions, and considers successful strategies for prevention and treatment of primary graft dysfunction.

KEYWORDS

Lung - allograft - dysfunction - transplant - complication

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R. Duane DavisM.D. 

Department of Surgery, Division of Thoracic Surgery, Duke University Medical Center

DUMC Box 3864, Rm. 3543 Hospital South, Durham, NC 27710

Email: davis053@mc.duke.edu