Analysis of Primary Graft Dysfunction (PGD) Risk Factors in Lung Transplantation (LuTx) Patients

Background: Primary graft dysfunction (PGD) is a form of acute lung injury (ALI) that occurs within 72 h after lung transplantation (LuTx) and is the most common early complication of the procedure. PGD is diagnosed and graded based on the ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen and chest X-ray results. PGD grade 3 increases recipient mortality and the chance of chronic lung allograft dysfunction (CLAD). Method: The aim of this retrospective study was to identify new PGD risk factors. The inclusion criteria were met by 59 patients, who all received transplants at the same center between 2010 and 2018. Donor data were taken from records provided by the Polish National Registry of Transplantation and analyzed in three variants: PGD 1-3 vs. PGD 0, PGD 3 vs. PGD 0 and PGD 3 vs. PGD 0-2. Results: A multiple-factor logistic regression model was used to identify decreasing recipient age; higher donor BMI and higher donor central venous pressure (CVP) for the PGD (of the 1-3 grade) risk factor. Conclusions: Longer cold ischemia time (CIT) and higher donor CVP proved to be independent risk factors of PGD 3.