The Glasgow Experience of Extended Myocardial Protection: A Novel Method of Implantation to Reduce Primary Graft Dysfunction After Heart Transplant

Singh, Sanjeet Singh Avtaar; De, Sudeep Das; Morcos, Karim; Hegazy, Yasser G.; Al-Haideri, H.; Dalzell, Jonathan R.; Berry, Colin; Doshi, Harikrishna; Al‐Attar, Nawwar; Curry, Philip A.

doi:10.6002/ect.2022.0227

Cited by 1 publication

(1 citation statement)

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“…Reducing known risk factors such as prolonged cardiopulmonary bypass time and implantation warm ischaemic time can improve rates of PGD [20,37]. Extended myocardial protection by instituting antegrade perfusion of the donor graft using cold blood cardioplegia alongside topical cooling led to a significantly reduced incidence of PGD [38]. Organ transport systems may also improve outcomes.…”

Section: Preventionmentioning

confidence: 99%

Acute complication posttransplant: primary allograft dysfunction

Brahmbhatt

Blitzer

Billia

et al. 2023

Current Opinion in Organ Transplantation

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Purpose of review Heart transplant is the gold standard treatment for patients with end-stage heart failure, improving both quality of life and survival. Despite advances in donor and recipient management, primary graft dysfunction (PGD) remains the most common cause of morbidity and mortality in the early posttransplant period. This review summarizes recent discoveries in the underlying pathophysiology, risk prediction and management of PGD. Recent findings The incidence of PGD appears to be rising and it is not clear whether this is due to better recognition or secular changes in transplant practice. The utilization of donation after circulatory death organs for transplant is a further consideration for the development of PGD. Organ transport systems and preservation techniques may help to prevent PGD. As some of the risk factors for developing PGD remain modifiable, we summarize the current evidence for prevention and management of PGD. Summary A better understanding will allow us to appropriately manage donors and recipients to reduce the complex interactions that lead to PGD. The development of an international consortium provides the opportunity for deep phenotyping and development of contemporary risk prediction models for PGD, which may reduce the incidence and consequent early mortality associated with heart transplantation.

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Section: Preventionmentioning

confidence: 99%