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Quantitative Evidence for Revising the Definition of Primary Graft Dysfunction after Lung Transplant AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Cantu, E., Diamond, J. M., Suzuki, Y., Lasky, J., Schaufler, C., Lim, B., Shah, R., Porteous, M., Lederer, D. J., Kawut, S. M., Palmer, S. M., Snyder, L. D., Hartwig, M. G., Lama, V. N., Bhorade, S., Bermudez, C., Crespo, M., McDyer, J., Wille, K., Orens, J., Shah, P. D., Weinacker, A., Weill, D., Wilkes, D., Roe, D., Hage, C., Ware, L. B., Bellamy, S. L., Christie, J. D., Lung Transplant Outcomes Grp 2018; 197 (2): 235–43

Abstract

Primary graft dysfunction (PGD) is a form of acute lung injury that occurs after lung transplantation. The definition of PGD was standardized in 2005. Since that time, clinical practice has evolved, and this definition is increasingly used as a primary endpoint for clinical trials; therefore, validation is warranted.We sought to determine whether refinements to the 2005 consensus definition could further improve construct validity.Data from the Lung Transplant Outcomes Group multicenter cohort were used to compare variations on the PGD definition, including alternate oxygenation thresholds, inclusion of additional severity groups, and effects of procedure type and mechanical ventilation. Convergent and divergent validity were compared for mortality prediction and concurrent lung injury biomarker discrimination.A total of 1,179 subjects from 10 centers were enrolled from 2007 to 2012. Median length of follow-up was 4 years (interquartile range?=?2.4-5.9). No mortality differences were noted between no PGD (grade 0) and mild PGD (grade 1). Significantly better mortality discrimination was evident for all definitions using later time points (48, 72, or 48-72 hours; P?

View details for PubMedID 28872353

View details for PubMedCentralID PMC5768905