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Primary graft dysfunction: pathophysiology to guide new preventive therapies.
Expert Rev Respir Med. 2017 02; 11(2):119-128.ER

Abstract

INTRODUCTION

Primary graft dysfunction (PGD) is a common complication of lung transplantation characterized by acute pulmonary edema associated with bilateral pulmonary infiltrates and hypoxemia in the first 3 post-operative days. Development of PGD is a predictor of poor short- and long-term outcomes after lung transplantation, but there are currently limited tools to prevent its occurrence. Areas covered: Several potentially modifiable donor, recipient, and operative risk factors for PGD have been identified. In addition, basic and translational studies in animals and ex vivo lung perfusion systems have identified several biomarkers and mechanisms of injury in PGD. In this review, we outline the clinical and genetic risk factors for PGD and summarize experimental data exploring PGD mechanisms, with a focus on strategies to reduce PGD risk and on potential novel molecular targets for PGD prevention. Expert commentary: Because of the clinical importance of PGD, development of new therapies for prevention and treatment is critically important. Improved understanding of the pathophysiology of clinical PGD provides a framework to explore novel agents to prevent or reverse PGD. Ex vivo lung perfusion provides a new opportunity for rapid development of therapeutics that target this devastating complication of lung transplantation.

Authors+Show Affiliations

a Department of Medicine , Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center , Nashville , TN , USA.a Department of Medicine , Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center , Nashville , TN , USA. b Department of Pathology, Microbiology and Immunology , Vanderbilt University Medical Center , Nashville , TN , USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28074663

Citation

Shaver, Ciara M., and Lorraine B. Ware. "Primary Graft Dysfunction: Pathophysiology to Guide New Preventive Therapies." Expert Review of Respiratory Medicine, vol. 11, no. 2, 2017, pp. 119-128.
Shaver CM, Ware LB. Primary graft dysfunction: pathophysiology to guide new preventive therapies. Expert Rev Respir Med. 2017;11(2):119-128.
Shaver, C. M., & Ware, L. B. (2017). Primary graft dysfunction: pathophysiology to guide new preventive therapies. Expert Review of Respiratory Medicine, 11(2), 119-128. https://doi.org/10.1080/17476348.2017.1280398
Shaver CM, Ware LB. Primary Graft Dysfunction: Pathophysiology to Guide New Preventive Therapies. Expert Rev Respir Med. 2017;11(2):119-128. PubMed PMID: 28074663.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Primary graft dysfunction: pathophysiology to guide new preventive therapies. AU - Shaver,Ciara M, AU - Ware,Lorraine B, Y1 - 2017/01/20/ PY - 2017/1/12/pubmed PY - 2017/7/25/medline PY - 2017/1/12/entrez KW - Primary graft dysfunction KW - acute lung injury KW - biomarkers KW - ischemia-reperfusion KW - lung transplantation KW - prevention KW - treatment SP - 119 EP - 128 JF - Expert review of respiratory medicine JO - Expert Rev Respir Med VL - 11 IS - 2 N2 - INTRODUCTION: Primary graft dysfunction (PGD) is a common complication of lung transplantation characterized by acute pulmonary edema associated with bilateral pulmonary infiltrates and hypoxemia in the first 3 post-operative days. Development of PGD is a predictor of poor short- and long-term outcomes after lung transplantation, but there are currently limited tools to prevent its occurrence. Areas covered: Several potentially modifiable donor, recipient, and operative risk factors for PGD have been identified. In addition, basic and translational studies in animals and ex vivo lung perfusion systems have identified several biomarkers and mechanisms of injury in PGD. In this review, we outline the clinical and genetic risk factors for PGD and summarize experimental data exploring PGD mechanisms, with a focus on strategies to reduce PGD risk and on potential novel molecular targets for PGD prevention. Expert commentary: Because of the clinical importance of PGD, development of new therapies for prevention and treatment is critically important. Improved understanding of the pathophysiology of clinical PGD provides a framework to explore novel agents to prevent or reverse PGD. Ex vivo lung perfusion provides a new opportunity for rapid development of therapeutics that target this devastating complication of lung transplantation. SN - 1747-6356 UR - https://www.unboundmedicine.com/medline/citation/28074663/Primary_graft_dysfunction:_pathophysiology_to_guide_new_preventive_therapies_ L2 - http://www.tandfonline.com/doi/full/10.1080/17476348.2017.1280398 DB - PRIME DP - Unbound Medicine ER -