Department of Anesthesiology, University of Maryland Medical Center, Baltimore, Maryland.
Department of Anesthesiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.
Curr Opin Anaesthesiol. 2020 Feb;33(1):10-16. doi: 10.1097/ACO.0000000000000811.
Primary graft dysfunction (PGD) is one of the most common complications after lung transplant and is associated with significant early and late morbidity and mortality. The cause of primary graft dysfunction is often multifactorial involving patient, donor, and operational factors. Diastolic dysfunction is increasingly recognized as an important risk factor for development of PGD after lung transplant and here we examine recent evidence on the topic.
Patients with end-stage lung disease are more likely to suffer from cardiovascular disease including diastolic dysfunction. PGD as result of ischemia-reperfusion injury after lung transplant is exacerbated by increased left atrial pressure and pulmonary venous congestion impacted by diastolic dysfunction. Recent studies on relationship between diastolic dysfunction and PGD after lung transplant show that patients with diastolic dysfunction are more likely to develop PGD with worse survival outcome and complicated hospital course.
Patients with diastolic dysfunction is more likely to suffer from PGD after lung transplant. From the lung transplant candidate selection to perioperative and posttransplant care, thorough evaluation and documentation diastolic dysfunction to guide patient care are imperative.
原发性移植物功能障碍（PGD）是肺移植后最常见的并发症之一，与显著的早期和晚期发病率和死亡率相关。原发性移植物功能障碍的原因通常是多因素的，涉及患者、供体和操作因素。舒张功能障碍越来越被认为是肺移植后发生 PGD 的重要危险因素，在此我们检查了该主题的最新证据。
终末期肺病患者更有可能患有心血管疾病，包括舒张功能障碍。肺移植后缺血再灌注损伤引起的 PGD 因舒张功能障碍导致的左心房压升高和肺静脉充血而加重。最近关于舒张功能障碍与肺移植后 PGD 之间关系的研究表明，舒张功能障碍患者更有可能发生 PGD，且生存结果更差，住院过程更复杂。
舒张功能障碍患者更有可能在肺移植后发生 PGD。从肺移植候选者的选择到围手术期和移植后护理，全面评估和记录舒张功能障碍以指导患者护理至关重要。
