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Report from a consensus conference on primary graft dysfunction after cardiac transplantation

Kobashigawa, Jon, MD ; Zuckermann, Andreas, MD ; Macdonald, Peter, MD, PhD ; Leprince, Pascal, MD, PhD ; Esmailian, Fardad, MD ; Luu, Minh, MBBS ; Mancini, Donna, MD ; Patel, Jignesh, MD, PhD ; Razi, Rabia, MD, MPH ; Reichenspurner, Hermann, MD, PhD ; Russell, Stuart, MD ; Segovia, Javier, MD, PhD ; Smedira, Nicolas, MD ; Stehlik, Josef, MD, MPH ; Wagner, Florian, MD, PhD

The Journal of heart and lung transplantation, 2014-04, Vol.33 (4), p.327-340 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Report from a consensus conference on primary graft dysfunction after cardiac transplantation
Autor: Kobashigawa, Jon, MD ; Zuckermann, Andreas, MD ; Macdonald, Peter, MD, PhD ; Leprince, Pascal, MD, PhD ; Esmailian, Fardad, MD ; Luu, Minh, MBBS ; Mancini, Donna, MD ; Patel, Jignesh, MD, PhD ; Razi, Rabia, MD, MPH ; Reichenspurner, Hermann, MD, PhD ; Russell, Stuart, MD ; Segovia, Javier, MD, PhD ; Smedira, Nicolas, MD ; Stehlik, Josef, MD, MPH ; Wagner, Florian, MD, PhD
Assuntos: cardiac transplantation ; consensus ; Cooperative Behavior ; Graft Rejection - diagnosis ; Graft Rejection - mortality ; Graft Rejection - physiopathology ; Graft Rejection - therapy ; Heart Transplantation - mortality ; Humans ; Interdisciplinary Communication ; Ischemic Preconditioning, Myocardial ; Myocardial Reperfusion Injury - diagnosis ; Myocardial Reperfusion Injury - mortality ; Myocardial Reperfusion Injury - physiopathology ; Myocardial Reperfusion Injury - therapy ; outcomes ; Postoperative Complications - diagnosis ; Postoperative Complications - mortality ; Postoperative Complications - physiopathology ; Postoperative Complications - therapy ; primary graft dysfunction ; Primary Graft Dysfunction - diagnosis ; Primary Graft Dysfunction - mortality ; Primary Graft Dysfunction - physiopathology ; Primary Graft Dysfunction - therapy ; primary graft failure ; Reoperation ; Risk Factors ; Surgery ; Survival Analysis
É parte de: The Journal of heart and lung transplantation, 2014-04, Vol.33 (4), p.327-340
Notas: content type line 25
ObjectType-News-3
SourceType-Conference Papers & Proceedings-1
ObjectType-Editorial-2
ObjectType-Commentary-1
ObjectType-Conference-4
Descrição: Although primary graft dysfunction (PGD) is fairly common early after cardiac transplant, standardized schemes for diagnosis and treatment remain contentious. Most major cardiac transplant centers use different definitions and parameters of cardiac function. Thus, there is difficulty comparing published reports and no agreed protocol for management. A consensus conference was organized to better define, diagnose, and manage PGD. There were 71 participants (transplant cardiologists, surgeons, immunologists and pathologists), with vast clinical and published experience in PGD, representing 42 heart transplant centers worldwide. State-of-the-art PGD presentations occurred with subsequent breakout sessions planned in an attempt to reach consensus on various issues. Graft dysfunction will be classified into primary graft dysfunction (PGD) or secondary graft dysfunction where there is a discernible cause such as hyperacute rejection, pulmonary hypertension, or surgical complications. PGD must be diagnosed within 24 hours of completion of surgery. PGD is divided into PGD-left ventricle and PGD-right ventricle. PGD-left ventricle is categorized into mild, moderate, or severe grades depending on the level of cardiac function and the extent of inotrope and mechanical support required. Agreed risk factors for PGD include donor, recipient, and surgical procedural factors. Recommended management involves minimization of risk factors, gradual increase of inotropes, and use of mechanical circulatory support as needed. Retransplantation may be indicated if risk factors are minimal. With a standardized definition of PGD, there will be more consistent recognition of this phenomenon and treatment modalities will be more comparable. This should lead to better understanding of PGD and prevention/minimization of its adverse outcomes.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Report from a consensus conference on primary graft dysfunction after cardiac transplantation

United States: Elsevier Inc

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