Report from a consensus conference on primary graft dysfunction after cardiac transplantation
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Report from a consensus conference on primary graft dysfunction after cardiac transplantation. / Kobashigawa, Jon; Zuckermann, Andreas; Macdonald, Peter; Leprince, Pascal; Esmailian, Fardad; Luu, Minh; Mancini, Donna; Patel, Jignesh; Razi, Rabia; Reichenspurner, Hermann; Russell, Stuart; Segovia, Javier; Smedira, Nicolas; Stehlik, Josef; Wagner, Florian; Consensus Conference participants.
in: J HEART LUNG TRANSPL, Jahrgang 33, Nr. 4, 04.2014, S. 327-340.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Report from a consensus conference on primary graft dysfunction after cardiac transplantation
AU - Kobashigawa, Jon
AU - Zuckermann, Andreas
AU - Macdonald, Peter
AU - Leprince, Pascal
AU - Esmailian, Fardad
AU - Luu, Minh
AU - Mancini, Donna
AU - Patel, Jignesh
AU - Razi, Rabia
AU - Reichenspurner, Hermann
AU - Russell, Stuart
AU - Segovia, Javier
AU - Smedira, Nicolas
AU - Stehlik, Josef
AU - Wagner, Florian
AU - Consensus Conference participants
N1 - Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
KW - Cooperative Behavior
KW - Graft Rejection/diagnosis
KW - Heart Transplantation/mortality
KW - Humans
KW - Interdisciplinary Communication
KW - Ischemic Preconditioning, Myocardial
KW - Myocardial Reperfusion Injury/diagnosis
KW - Postoperative Complications/diagnosis
KW - Primary Graft Dysfunction/diagnosis
KW - Reoperation
KW - Risk Factors
KW - Survival Analysis
U2 - 10.1016/j.healun.2014.02.027
DO - 10.1016/j.healun.2014.02.027
M3 - SCORING: Journal article
C2 - 24661451
VL - 33
SP - 327
EP - 340
JO - J HEART LUNG TRANSPL
JF - J HEART LUNG TRANSPL
SN - 1053-2498
IS - 4
ER -