ArticleJHLT open2026
Primary graft dysfunction prevention strategies in the perioperative period.
Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- The impact of preoperative mechanical support on long-term survival following early lung re-transplantation for graft failure.JHLT open · 2026Article
- Evaluating a Novel Cell-Free Preservation Solution for Human Cardiomyocyte Protection: A Proof-of-Concept Study.BioMed research international · 2026Article
- Lung transplantation from polytrauma donors: beyond primary graft dysfunction.Frontiers in medicine · 2026Article
- Undersized lung grafts in chronic obstructive pulmonary disease transplant recipients: risk factor or acceptable compromise?Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Primary graft dysfunction (PGD) remains a leading cause of early morbidity and mortality after heart and lung transplantation. It results from a multifactorial process involving ischemia-reperfusion injury, inflammatory and immune responses, and donor-, recipient-, and procedural factors. Despite advances in perioperative management, PGD continues to adversely affect both short- and long-term transplant outcomes. Methods: This narrative review synthesizes contemporary evidence and consensus recommendations from the International Society for Heart and Lung Transplantation (ISHLT) and recent clinical studies to delineate perioperative strategies aimed at preventing PGD in heart and lung transplantation. Focus areas include donor and recipient optimization, organ preservation strategies, intraoperative management, and emerging perfusion technologies. Results: In heart transplantation, modifiable factors such as pre-transplant amiodarone exposure and donor-recipient mismatch increase PGD risk. Among preservation methods, hypothermic oxygenated perfusion has demonstrated reductions in PGD incidence, while controlled hypothermia has been associated with reduced PGD rates in observational studies. Normothermic ex vivo perfusion has shown improved graft preservation. In lung transplantation, the use of low-potassium dextran preservation solutions is associated with lower PGD rates. Ex vivo lung perfusion improves allograft utilization and may reduce PGD incidence. Implantation techniques such as off-pump lung transplantation or veno-arterial extracorporeal membrane oxygenation, rather than cardiopulmonary bypass, have been associated with lower PGD rates. Conclusions: Every step of the transplant process is important in reducing the risk of PGD. Emerging machine perfusion technologies represent a promising advancement to enhance graft utilization, reduce PGD incidence, and improve overall outcomes following heart and lung transplantation.
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