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Friday, August 26 2016

Q: What is the most likely cause of primary graft dysfunction (PGD) in new lung transplant patients? 

Answer:  Ischemia-reperfusion injury

About 10-15 percent of patients develop PGD after lung transplantation. It has been classified into four grades which determined increased 90 days mortality.

  • Grade 0 – P/F ratio more than 300 with normal chest x-ray 
  • Grade 1 – P/F ratio more than 300  but with diffuse allograft infiltrates on chest x-ray 
  • Grade 2 – P/F ratio 200 to 300 
  • Grade 3 – P/F ratio less than 200


Christie JD, Carby M, Bag R, et al. Report of the ISHLT Working Group on Primary Lung Graft Dysfunction part II: definition. A consensus statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2005; 24:1454. 


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