scholarly journals Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors

2016 ◽  
Vol 14 (4) ◽  
pp. 567-572 ◽  
Author(s):  
Douglas Bastos Neves ◽  
Marcela Balbo Rusi ◽  
Luiz Gustavo Guedes Diaz ◽  
Paolo Salvalaggio
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Diagnostic Criteria ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Allograft Dysfunction ◽  
Pubmed Database ◽  
Early Allograft Dysfunction

ABSTRACT Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: “primary graft dysfunction”, “early allograft dysfunction”, “primary non-function” and “liver transplantation”. Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies.

scholarly journals Extracellular histones are clinically associated with primary graft dysfunction in human liver transplantation

RSC Advances ◽  
2019 ◽  
Vol 9 (18) ◽  
pp. 10264-10271 ◽  
Author(s):  
Xiuhui Li ◽  
Chunyan Gou ◽  
Yanhua Pang ◽  
Yakun Wang ◽  
Yan Liu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Human Liver ◽  
Ischemia Reperfusion ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Inflammatory Conditions ◽  
Extracellular Histones

Extracellular histones have been involved in numerous inflammatory conditions such as ischemia/reperfusion (I/R) injury, trauma, and infection.

Primary Graft Dysfunction (PGD) Following Lung Transplantation

2018 ◽  
Vol 39 (02) ◽  
pp. 148-154 ◽  
Author(s):  
Rupal Shah ◽  
Joshua Diamond
Keyword(s):  
Risk Factors ◽  
Lung Transplantation ◽  
Ischemia Reperfusion ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Ex Vivo Lung Perfusion ◽  
Risk Of Death ◽  
Predictive Algorithms ◽  
Increased Risk ◽  
Consensus Statements

AbstractPrimary graft dysfunction (PGD) is a form of acute lung injury that results from ischemia reperfusion injury (IRI) and is the major cause of early posttransplant morbidity and mortality. Patients who survive PGD have decreased quality of life, an increased risk of chronic lung allograft dysfunction, specifically bronchiolitis obliterans syndrome, and a significantly increased risk of death. In 2017, the International Society for Heart and Lung Transplantation released updated consensus statements on the PGD definition, most up-to-date PGD risk factors, mechanisms of PGD development, and the state-of-the-art for PGD therapeutics. Risk factor identification has led to the development of PGD predictive algorithms, although their clinical utility remains limited. Ongoing areas of controversy and discussion include further refinements to the PGD grading scheme to account for technologic advances such as extracorporeal membrane oxygenation and the increased utilization of high flow nasal cannula, the use of PGD as an outcome measure in clinical trials of ex vivo lung perfusion, enhancement of predictive algorithms incorporating biochemical risk factors, and the need for development of therapies targeted at improving PGD outcomes.

scholarly journals Minimizing Ischemia Reperfusion Injury in Xenotransplantation

2021 ◽  
Vol 12 ◽  
Author(s):  
Parth M. Patel ◽  
Margaret R. Connolly ◽  
Taylor M. Coe ◽  
Anthony Calhoun ◽  
Franziska Pollok ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Reperfusion Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Associated Injury ◽  
Genetic Modifications ◽  
Injury Mechanisms ◽  
Human Primate

The recent dramatic advances in preventing “initial xenograft dysfunction” in pig-to-non-human primate heart transplantation achieved by minimizing ischemia suggests that ischemia reperfusion injury (IRI) plays an important role in cardiac xenotransplantation. Here we review the molecular, cellular, and immune mechanisms that characterize IRI and associated “primary graft dysfunction” in allotransplantation and consider how they correspond with “xeno-associated” injury mechanisms. Based on this analysis, we describe potential genetic modifications as well as novel technical strategies that may minimize IRI for heart and other organ xenografts and which could facilitate safe and effective clinical xenotransplantation.

scholarly journals Biomarkers of Cellular Apoptosis and Necrosis in Donor Myocardium Are Not Predictive of Primary Graft Dysfunction

2016 ◽  
pp. 251-257 ◽  
Author(s):  
O. SZARSZOI ◽  
J. BESIK ◽  
M. SMETANA ◽  
J. MALY ◽  
M. URBAN ◽  
...  
Keyword(s):  
Cell Death ◽  
Prospective Study ◽  
Reperfusion Injury ◽  
Caspase 3 ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Transplant Recipients ◽  
Primary Graft Dysfunction ◽  
Graft Dysfunction ◽  
Apoptosis Markers

Primary graft dysfunction (PGD) is a life-threatening complication among heart transplant recipients and a major cause of early mortality. Although the pathogenesis of PGD is still unclear, ischemia/reperfusion injury has been identified as a predominant factor. Both necrosis and apoptosis contribute to the loss of cardiomyocytes during ischemia/reperfusion injury, and this loss of cells can ultimately lead to PGD. The aim of our prospective study was to find out whether cell death, necrosis and apoptosis markers present in the donor myocardium can predict PGD. The prospective study involved 64 consecutive patients who underwent orthotopic heart transplantation at our institute between September 2010 and January 2013. High-sensitive cardiac troponin T (hs-cTnT) as a marker of minor myocardial necrosis was detected from arterial blood samples before the donor’s pericardium was opened. Apoptosis (caspase-3, active + pro-caspase-3, bcl-2, TUNEL) was assessed from bioptic samples taken from the right ventricle prior graft harvesting. In our study, 14 % of transplant recipients developed PGD classified according to the standardized definition proposed by the ISHLT Working Group. We did not find differences between the groups in regard to hs-cTnT serum levels. The mean hs-cTnT value for the PGD group was 57.4±22.9 ng/l, compared to 68.4±10.8 ng/l in the group without PGD. The presence and severity of apoptosis in grafted hearts did not differ between grafts without PGD and hearts that subsequently developed PGD. In conclusion, our findings did not demonstrate any association between measured myocardial cell death, necrosis or apoptosis markers in donor myocardium and PGD in allograft recipients. More detailed investigations of cell death signaling pathways in transplanted hearts are required.

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