医学
肺移植
肺
低氧血症
移植
重症监护医学
弥漫性肺泡损伤
外科
内科学
急性呼吸窘迫
作者
Mallory Hunt,Edward Cantu
出处
期刊:Current Opinion in Organ Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2023-04-13
卷期号:28 (3): 180-186
被引量:3
标识
DOI:10.1097/mot.0000000000001065
摘要
Purpose of review Primary graft dysfunction (PGD) is a clinical syndrome occurring within the first 72 h after lung transplantation and is characterized clinically by progressive hypoxemia and radiographically by patchy alveolar infiltrates. Resulting from ischemia-reperfusion injury, PGD represents a complex interplay between donor and recipient immunologic factors, as well as acute inflammation leading to alveolar cell damage. In the long term, chronic inflammation invoked by PGD can contribute to the development of chronic lung allograft dysfunction, an important cause of late mortality after lung transplant. Recent findings Recent work has aimed to identify risk factors for PGD, focusing on donor, recipient and technical factors both inherent and potentially modifiable. Although no PGD-specific therapy currently exists, supportive care remains paramount and early initiation of ECMO can improve outcomes in select patients. Initial success with ex-vivo lung perfusion platforms has been observed with respect to decreasing PGD risk and increasing lung transplant volume; however, the impact on survival is not well delineated. Summary This review will summarize the pathogenesis and clinical features of PGD, as well as highlight treatment strategies and emerging technologies to mitigate PGD risk in patients undergoing lung transplantation.
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