PGD in Transplantation

 Q: All of the following are considered as causes of primary graft dysfunction (PGD) EXCEPT? (select one) 

A) preexisting donor heart disease 

B) reperfusion injury 

C) massive blood transfusion 

D)ischemia during the process of organ recovery

Answer: C

The consensus conference on primary graft dysfunction after cardiac transplantation (Reference # 1) defines PGD as: "Left Ventricular (LV), Right Ventricular (RV) or biventricular dysfunction that occurs within 24 hours after surgery and is not associated with a discernible cause such as hyperacute rejection, pulmonary hypertension, or uncontrolled intraoperative bleeding resulting in massive blood product transfusions and prolonged graft ischemic time". 

Hyperacute rejection, volume overload, and pulmonary hypertension in the recipient's heart are all considered as secondary graft dysfunction. 

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Reference:

1. Kobashigawa J, Zuckermann A, Macdonald P, et al. Report from a consensus conference on primary graft dysfunction after cardiac transplantation. J Heart Lung Transplant 2014; 33:327.