A Focused Review on Primary Graft Dysfunction after Clinical Lung Transplantation: A Multilevel Syndrome.
Cells
; 11(4)2022 02 21.
Article
en En
| MEDLINE
| ID: mdl-35203392
ABSTRACT
Primary graft dysfunction (PGD) is the clinical syndrome of acute lung injury after lung transplantation (LTx). However, PGD is an umbrella term that encompasses the ongoing pathophysiological and -biological mechanisms occurring in the lung grafts. Therefore, we aim to provide a focused review on the clinical, physiological, radiological, histological and cellular level of PGD. PGD is graded based on hypoxemia and chest X-ray (CXR) infiltrates. High-grade PGD is associated with inferior outcome after LTx. Lung edema is the main characteristic of PGD and alters pulmonary compliance, gas exchange and circulation. A conventional CXR provides a rough estimate of lung edema, while a chest computed tomography (CT) results in a more in-depth analysis. Macroscopically, interstitial and alveolar edema can be distinguished below the visceral lung surface. On the histological level, PGD correlates to a pattern of diffuse alveolar damage (DAD). At the cellular level, ischemia-reperfusion injury (IRI) is the main trigger for the disruption of the endothelial-epithelial alveolar barrier and inflammatory cascade. The multilevel approach integrating all PGD-related aspects results in a better understanding of acute lung failure after LTx, providing novel insights for future therapies.
Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Trasplante de Pulmón
/
Lesión Pulmonar Aguda
/
Disfunción Primaria del Injerto
Tipo de estudio:
Etiology_studies
Idioma:
En
Revista:
Cells
Año:
2022
Tipo del documento:
Article