68: Historical Trends of Primary Graft Failure after Heart Transplantation

Gómez‐Bueno, Manuel; Barcelo, J.M.; Segovia, J.; Cobo, Marta; Mirelis, J. González; Sufrate, E.; García‐Pavía, Pablo; Alonso‐Pulpón, Luis

doi:10.1016/j.healun.2008.11.745

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“…In a retrospective review of 621 heart transplant patients from 1984 to 2006, they reported an overall incidence of severe PGD of 9 %, with 30-day mortality of 80 %. Detailed breakdown of data into four time periods revealed a significant increase in severe PGD (12.4 %) in the most recent period, 2000-2006, but lower 30-day mortality (67 %) for the same period [51].…”

Section: Discussionmentioning

confidence: 95%

Primary Graft Dysfunction After Heart Transplantation

et al. 2014

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Primary graft dysfunction (PGD) is a lifethreatening complication of heart transplantation that presents as left, right, or biventricular dysfunction occurring within the first 24 hours of transplant surgery for which there is no identifiable secondary cause. Myocardial injury caused by acute catecholamine toxicity and the release of multiple proinflammatory mediators in the donor, followed by ischaemiareperfusion injury sustained during retrieval, have been considered the predominant pathogenetic processes leading to PGD. Donor, recipient, and procedural factors contribute to the development and severity of the clinical syndrome. The changing donor and recipient characteristics over the last two decades, particularly the increasing donor and recipient age, have led to heightened risk of PGD. PGD is graded from mild to severe depending on the extent of circulatory support that is required to maintain haemodynamic stability and vital organ function. While advances in acute mechanical support devices have improved the outlook for patients with PGD, the rate of mortality remains high for those with severe PGD, reaching 40 %. Potential approaches to preventing or minimising the severity of PGD include optimising donor management, donor heart preservation, and donor/recipient matching.

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Section: Discussionmentioning

confidence: 95%