Publication: Akciğer Transplantasyonu Sonrası Primer Greft Disfonksiyonu
Abstract
Primer greft disfonksiyonu (PGD), akciğer nakli sonrası karşılaşı- lan, mortalite ve morbiditenin en önemli nedeni olan, akut akci- ğer hasarının ciddi bir formudur. Yaygın alveol hasarı ve akciğer ödemi nedeniyle progresif hipoksemiye yol açan radyolojik olarak pulmoner infiltrasyon ile karakterize bir klinik tablodur. İskemi ve reperfüzyon nedeniyle oluşan inflamatuvar ve immünolojik ya- nıt patofizyolojide önemli rol oynamaktadır. PGD riskini en aza indirmek amacıyla; iskemi süresinin azaltılması, reperfüzyonun fects short- and long-term outcomes, the donor organ is the leading optimizasyonu, prostaglandin seviyelerinin düzenlenmesi, hemo- factor affecting these adverse ramifications. To minimize the risk of dinaminin kontrolü, hormon replasmanı, ventilatör yönetimi ve donör akciğeri hazırlama stratejileri üzerinde yapılan araştırma- larda bazı prosedürler önerilmektedir. Bu derlemede PGD'nin replacement therapy, ventilator management are carried out; for epidemiyolojisi, patofizyolojisi, moleküler ve genetik belirteçler research regarding donor lung preparation strategies, certain pro- ile teknik gelişmeler irdelenecektir
Primary graft dysfunction (PGD) is a severe form of acute lung injury that is a major cause of early morbidity and mortality encountered after lung transplantation. PGD is diagnosed by pulmonary oedema with diffuse alveolar damage that manifests clinically as progressive hypoxemia with radiographic pulmonary infiltrates. Inflammatory and immunological response caused by ischaemia and reperfusion is important with regard to pathophysiology. PGD affects short- and long-term outcomes, the donor organ is the leading factor affecting these adverse ramifications. To minimize the risk of PGD, reduction of lung ischaemia time, reperfusion optimisation, prostaglandin level regulation, haemodynamic control, hormone replacement therapy, ventilator management are carried out; for research regarding donor lung preparation strategies, certain procedures are recommended. In this review, recent updates in epidemiology, pathophysiology, molecular and genetic biomarkers and technical developments affecting PGD are described
Primary graft dysfunction (PGD) is a severe form of acute lung injury that is a major cause of early morbidity and mortality encountered after lung transplantation. PGD is diagnosed by pulmonary oedema with diffuse alveolar damage that manifests clinically as progressive hypoxemia with radiographic pulmonary infiltrates. Inflammatory and immunological response caused by ischaemia and reperfusion is important with regard to pathophysiology. PGD affects short- and long-term outcomes, the donor organ is the leading factor affecting these adverse ramifications. To minimize the risk of PGD, reduction of lung ischaemia time, reperfusion optimisation, prostaglandin level regulation, haemodynamic control, hormone replacement therapy, ventilator management are carried out; for research regarding donor lung preparation strategies, certain procedures are recommended. In this review, recent updates in epidemiology, pathophysiology, molecular and genetic biomarkers and technical developments affecting PGD are described