724 Primary Graft Dysfunction (PGD) vs Transfusion-Related Lung Injury (TRLI) in Lung Transplantation (LT): Can These Entities Be Differentiated Based on the Current ISHLT PGD Definition?

Perioperative Management of Bleeding and Transfusion for Lung Transplantation

“…8 It is challenging to differentiate between PGD and TRALI in the first place, given that the current International Society for Heart and Lung Transplantation definition and grading of PGD does not take into account the number of transfused blood products, and the clinical presentation of these 2 syndromes is quite similar. 9 Even though centers routinely administer leukoreduced blood products, the implications for the immunosuppressed lung transplant patient includes the development of transfusion-associated graft-versus-host disease from exposure to donor lymphocytes and the development of human leukocyte antigen (HLA) antibodies, which may influence rates of acute and chronic rejection. 8 Preoperative transfusion of red cells and platelets have been associated with the development of HLA antibodies in the recipient, which substantially reduce the ability to match a suitable donor organ.…”

Examining Bleeding Risk, Transfusion-related Complications, and Strategies to Reduce Transfusions in Lung Transplantation

“…8 Although transfusion is repeatedly linked to severe primary graft dysfunction, this is difficult to clinically differentiate from other forms of transfusion-related lung injury or transfusionassociated circulatory overload. 9 Analyses of single-center and multicenter cohorts of lung transplant patients highlight the association between blood loss and transfusion with worse early allograft function, primary graft dysfunction, chronic rejection, and both early and late mortality. [10][11][12][13] Thus, correcting preoperative anemia and mitigating blood loss is critical to improve patient outcomes.…”