Primary Graft Dysfunction

A form of ischemia-reperfusion injury occurring in the early period following transplantation. Significant pathophysiological changes in MITOCHONDRIA are the main cause of the dysfunction. It is most often seen in the transplanted lung, liver, or kidney and can lead to GRAFT REJECTION.

Also Known As:

Networked: 347 relevant articles (10 outcomes, 23 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Reperfusion Injury
2.	Thrombosis (Thrombus)
3.	Brain Death (Brain Dead)
4.	Bronchiolitis Obliterans
5.	Lung Injury

Experts

1.	Christie, Jason D: 29 articles (10/2015 - 06/2005)
2.	Ware, Lorraine B: 17 articles (02/2015 - 01/2007)
3.	Diamond, Joshua M: 16 articles (10/2015 - 10/2010)
4.	Kawut, Steven M: 16 articles (03/2014 - 12/2005)
5.	Lung Transplant Outcomes Group: 15 articles (02/2015 - 11/2007)
6.	Weinacker, Ann: 14 articles (06/2014 - 01/2007)
7.	Lederer, David J: 14 articles (06/2014 - 07/2009)
8.	Keshavjee, Shaf: 13 articles (08/2015 - 01/2004)
9.	Crespo, Maria: 13 articles (06/2014 - 11/2010)
10.	Palmer, Scott M: 12 articles (12/2014 - 11/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Primary Graft Dysfunction:

1.	Prostaglandins D (PGD)IBA 06/01/2015 - "Outcome measures for lung recipients were early survival and primary graft dysfunction (PGD) rates. " 02/01/2015 - "We aimed to determine whether the pTLC ratio is associated with the risk of primary graft dysfunction (PGD) after bilateral LTx (BLT). " 11/01/2014 - "The odds of developing severe primary graft dysfunction (PGD) in the Heavy Alcohol Use group versus the No Alcohol Use group were 8.7 times greater (95% confidence interval 1.427 to 53.404, p = 0.019) after controlling for factors known to be associated with PGD. " 03/01/2014 - "Biologic pathways with significant genetic conservation across human populations have been implicated in the pathogenesis of primary graft dysfunction (PGD). " 02/01/2014 - "For recipients, early survival and the rate of primary graft dysfunction (PGD) grade 3 were the main outcome measures. "
2.	Aprotinin (Trasylol)FDA Link 01/01/2011 - "A randomized, placebo-controlled trial of aprotinin to reduce primary graft dysfunction following lung transplantation." 02/01/2010 - "Aprotinin in lung transplantation is associated with an increased incidence of primary graft dysfunction." 02/01/2010 - "A recent study found a significant reduction in severe (grade III) primary graft dysfunction (PGD) in lung transplantation where aprotinin had been used. "
3.	PerfadexIBA 04/01/2011 - "Perfadex was associated with a reduced incidence of primary graft dysfunction at 48 hours (OR = 0.23 [0.08 to 0.68], p = 0.008). "
4.	dicarboxydine (DCD)IBA 05/01/2015 - "There was also no difference between DCD and DBD in a pooled analysis of 5 studies reporting on primary graft dysfunction (RR 1.09, 95% CI 0.68-1.73, p = 0.7, I(2) = 0%) and 4 studies reporting on acute rejection (RR 0.72, 95% CI 0.49-1.05, p = 0.09, I(2) = 0%). " 01/01/2016 - "Patients from the DCD group had significantly higher incidence of primary graft dysfunction grade 3 at the end of the procedure (P = 0.014), and significantly lower pO2/FiO2 ratio during the first 24 h after the procedure (P = 0.018). " 09/01/2014 - "Donation after circulatory death (DCD) livers are at markedly increased risk of primary graft dysfunction and biliary tract ischaemia. " 06/01/2013 - "However, livers procured after DCD are at increased risk of primary graft dysfunction and biliary tract ischaemia. " 09/01/2012 - "However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. "
5.	CytokinesIBA 02/01/2009 - "Plasma cytokines and chemokines in primary graft dysfunction post-lung transplantation." 11/01/2008 - "Primary graft dysfunction (PGD) following lung transplantation (LT) is associated with an activation of the inflammatory cascade and release of cytokines. " 07/01/2008 - "Primary graft dysfunction induces proinflammatory cytokines that can upregulate donor HLA-II antigens on the allograft. " 08/01/2007 - "This review summarizes human and animal studies on biomarkers in primary graft dysfunction, including cytokines and markers of acute inflammation, VEGF, endothelial markers and adhesion molecules, markers of coagulation and fibrinolysis and markers of lung epithelial injury. " 01/01/1996 - "The presence of elevated serum cytokines interleukin 6 and tumor necrosis factor with hepatic graft dysfunction, as well as the historical benefit of plasmapheresis in fulminant hepatic failure-associated coma suggest a possible role for plasmapheresis therapy in the management of primary graft dysfunction in liver transplantation. "
6.	Biological Markers (Surrogate Marker)IBA 08/01/2007 - "Biomarkers of lung injury in primary graft dysfunction following lung transplantation." 08/01/2007 - "Similarities to the literature in acute lung injury/acute respiratory distress syndrome are highlighted where appropriate, and future directions for research on the role of biomarkers in primary graft dysfunction are suggested." 08/01/2007 - "However, in contrast to acute lung injury/acute respiratory distress syndrome, in which biomarkers in plasma, urine and lung edema fluid have prognostic and pathogenetic value, the role of biomarkers in primary graft dysfunction has been less thoroughly explored. " 09/01/2012 - "We aimed to identify combinations of biomarkers to enhance the definition of primary graft dysfunction (PGD) for translational research. " 09/01/2012 - "A panel of lung injury biomarkers enhances the definition of primary graft dysfunction (PGD) after lung transplantation."
7.	AntibodiesIBA 12/01/2014 - "Retransplantation (odds ratio [OR] = 2.7, 95% confidence interval [CI] 1.1 to 6.5, p = 0.03), pre-operative HLA antibodies (OR = 2.1, 95% CI 1.2 to 3.4, p = 0.003) and primary graft dysfunction (PGD) score Grade 2 or 3 at 48 hours (OR = 2.6, 95% CI 1.5 to 4.6, p = 0.001) were associated with early DSA development. " 08/01/2013 - "The goals of this study were to determine the prevalence of pre-existing antibodies (Abs) to the SAgs in pulmonary diseases and the association between pre-existing Abs to SAgs and the development of primary graft dysfunction (PGD), donor-specific antibodies (DSA), and chronic rejection. "
8.	Vascular Endothelial Growth Factor A (Vascular Endothelial Growth Factor)IBA 08/01/2007 - "This review summarizes human and animal studies on biomarkers in primary graft dysfunction, including cytokines and markers of acute inflammation, VEGF, endothelial markers and adhesion molecules, markers of coagulation and fibrinolysis and markers of lung epithelial injury. "
9.	OxygenIBA 12/01/2006 - "We assessed the utility of reduced pulmonary vein gas (PVG) partial pressure of oxygen (PO2) in predicting the incidence of primary graft dysfunction. " 01/01/2006 - "Severe primary graft dysfunction was defined as a PaO2/inspired oxygen fraction of less than 150 with diffuse infiltrate on the radiograph in absence of other causes. " 09/01/2007 - "Early Trends in PaO(2)/fraction of inspired oxygen ratio predict outcome in lung transplant recipients with severe primary graft dysfunction." 01/01/2007 - "In multivariate analysis of the validation cohort, the donor score in bilateral LTx was significantly associated with post-transplant ratio of arterial oxygen tension and inspired oxygen fraction (coefficient = -16.19, p = 0.002), primary graft dysfunction grade (coefficient = 0.21, p < 0.0001), and intubation hours (coefficient = 0.05, p = 0.04); however, a significant association was not seen in single LTx. " 01/01/2006 - "The mean PaO2/inspired oxygen fraction at 6 hours in this cohort was 252 +/- 123 mm Hg. The median number of days on the ventilator was 2. More importantly, the incidence of severe primary graft dysfunction in this cohort was 2.0%. "
10.	Nitric Oxide (Nitrogen Monoxide)FDA Link 03/01/2012 - "BLT recipients had a significantly longer mean waitlist time (240 vs. 125 days), significantly higher systolic (51 ± 18 vs. 40 ± 11 mmHg) pulmonary artery pressures, were placed on cardiopulmonary bypass more frequently (67 vs. 31%), had a higher incidence of primary graft dysfunction (63 vs. 17%), more frequently were given prolonged peri-operative inhaled nitric oxide and more frequently required prolonged post-operative mechanical ventilatory support (6.0 vs. 1.7 days). " 07/01/2009 - "Effects of inhaled nitric oxide on primary graft dysfunction in lung transplantation." 01/01/2010 - "Severe Primary Graft Dysfunction (PGD) was suspected and nitric oxide (NO) and independent lung ventilation (ILV) initiated. "

Therapies and Procedures

1.	Lung Transplantation 06/01/2012 - "Radiological patterns of primary graft dysfunction after lung transplantation evaluated by 64-multi-slice computed tomography: a descriptive study." 11/01/2010 - "This study assessed the protective effect of NAC on primary graft dysfunction after lung transplantation. " 11/01/2009 - "Risk factors for early primary graft dysfunction after lung transplantation: a registry study." 11/01/2007 - "This study could not demonstrate a significant effect of inhaled NO during the first 30 minutes of reperfusion in the prevention of neutrophil injury and primary graft dysfunction after lung transplantation." 07/01/2006 - "Although the primary graft dysfunction grade correlated with the early posttransplantation outcomes, for the purposes of description and further studies, primary graft dysfunction in bilateral and single lung transplantation should be considered separately."
2.	Transplants (Transplant) 09/15/2001 - "It also showed slower clearance of University of Wisconsin solution in grafts with subsequent primary graft dysfunction, suggesting a slower recovery of bile secretion. " 01/01/2016 - "The incidence of severe primary graft dysfunction was comparable up to 48 h post-transplant and was significantly increased in the RP cohort 72 h post-transplant (2.2% AP vs 14.8% RP, P = 0.016). " 09/01/2014 - "All 26 patients underwent successful dual organ transplant, without any episodes of primary graft dysfunction. " 02/27/2014 - "Although D-MELD Class C patients had larger graft volume-to-standard liver volume ratio (P<0.01) and received right lobe grafts more often (P<0.01), they still exhibited significantly higher rates of primary graft dysfunction (P<0.01) and in-hospital mortality (P<0.01). " 03/01/2013 - "Conditional 5-year survivals in patients surviving the first year were 78.9% and 88.3% for the primary graft dysfunction and nonprimary graft dysfunction groups, respectively (P = .18). "
3.	Extracorporeal Membrane Oxygenation (ECMO) 12/01/2015 - "Despite delayed left heart adaptation and primary graft dysfunction requiring prolonged extracorporeal membrane oxygenation, the recipient was eventually discharged without activity limitations. " 02/01/2014 - "Ten patients needed ECMO for primary graft dysfunction. " 11/01/2013 - "The need for postoperative extracorporeal membrane oxygenation for primary graft dysfunction was similar in both groups. " 06/01/2013 - "The mean duration of CPB was 111±19 min. The occurrence of primary graft dysfunction and the need for extracorporeal membrane oxygenation tended to be lower, but did not reach significance. " 03/01/2009 - "Long-term survival of patients with primary graft dysfunction requiring ECMO (overall and weaned) was inferior to that of patients who did not require ECMO."
4.	Transplantation (Transplant Recipients) 12/01/2014 - "In ReTx populations, factors conferring worse outcomes include intensive care unit admission, unilateral transplantation, poor functional status, and primary graft dysfunction as the indication for retransplantation (p < 0.05). " 06/01/2014 - "After transplantation, primary graft dysfunction (PGD72 grade 3, 32% vs. 28%, EVLP versus Standard, P = 1), mortality at 30 days (0% vs. 0%, P = 1), and overall survival (71% vs. 86%, EVLP versus Standard P = 0.27) were not different between groups. " 10/01/2013 - "When these lungs were transplanted, low rates of primary graft dysfunction were achieved and long-term survival was comparable with standard transplantation. " 05/01/2013 - "The use of A3R agonists may be a novel therapeutic strategy to prevent lung IR injury and primary graft dysfunction after transplantation." 11/01/2012 - "The primary end point was the incidence of primary graft dysfunction grade 3 at 72 hours after transplantation. "
5.	Liver Transplantation 04/01/2014 - "Primary graft dysfunction after liver transplantation." 10/01/2012 - "Low values of left ventricular ejection time in the post-anhepatic phase may be associated with occurrence of primary graft dysfunction after orthotopic liver transplantation: results of a single-centre case-control study." 08/01/2011 - "In liver transplantation, IRI increases the likelihood of primary graft dysfunction and is associated with significant morbidity. " 02/01/2011 - "Primary graft dysfunction still represents a major challenge in liver transplantation. " 04/27/2004 - "Preservation injury is a major cause of primary graft dysfunction in liver transplantation (LT). "