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Summary of the International Society for Heart and Lung Transplantation (ISHLT) Consensus Conference on Graft Dysfunction within the First 72 hours after Heart Transplantation : A 10-year Update

Kobashigawa, Jon ; Zuckermann, Andreas ; Potena, Luciano ; Ardehali, Abbas ; Berman, Marius ; Chang, Patricia P ; Esmailian, Fardad ; Farr, Maryjane ; Hall, Shelley and Hsich, Eileen , et al. (2026) In The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Abstract

Primary graft dysfunction (PGD), defined as ventricular dysfunction occurring within 24 hours after heart transplantation (HTx) in the absence of identifiable secondary causes, remains a major contributor to early post-transplant mortality. Over the past decade, there has been a growing understanding of the burden of PGD, the clinical relevance of PGD classification and severity grading, and efforts to identify donor-, recipient-, and procedural-related risk factors and biomarkers predictive of PGD. Significant advancements have been made in donor heart preservation and procurement technologies, as well as in utilization and outcomes of mechanical circulatory support for managing severe PGD patients. However, existing... (More)

Primary graft dysfunction (PGD), defined as ventricular dysfunction occurring within 24 hours after heart transplantation (HTx) in the absence of identifiable secondary causes, remains a major contributor to early post-transplant mortality. Over the past decade, there has been a growing understanding of the burden of PGD, the clinical relevance of PGD classification and severity grading, and efforts to identify donor-, recipient-, and procedural-related risk factors and biomarkers predictive of PGD. Significant advancements have been made in donor heart preservation and procurement technologies, as well as in utilization and outcomes of mechanical circulatory support for managing severe PGD patients. However, existing risk-stratification tools have limitations and perform poorly in predicting PGD in the contemporary era. In addition, prevention and management strategies of PGD remain variable, largely influenced by center-specific practices and the lack of objective data. Moreover, vasoplegia often co-exists with PGD, and their complex interplay remains incompletely understood. To address these gaps, a consensus conference was organized on April 9, 2024, endorsed by the International Society for Heart and Lung Transplantation. The conference represented a collaborative multidisciplinary effort by international experts in cardiothoracic transplantation to reassess the consensus definition and grading of PGD, established more than a decade ago, and provide guidance on the utility of risk stratification tools, potential strategies to mitigate the risk of PGD, and the efficacy of current treatment options. The nature of this consensus is to establish a foundation and pave the way for future studies. Findings and consensus statements are presented.

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publication status
epub
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in
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
publisher
Elsevier
external identifiers
  • pmid:41823895
ISSN
1557-3117
DOI
10.1016/j.healun.2025.12.029
language
English
LU publication?
yes
additional info
Crown Copyright © 2026. Published by Elsevier Inc. All rights reserved.
id
76597a0d-36a9-418b-82cc-1fe4bf310354
date added to LUP
2026-03-16 11:44:12
date last changed
2026-03-18 16:05:48
@article{76597a0d-36a9-418b-82cc-1fe4bf310354,
  abstract     = {{<p>Primary graft dysfunction (PGD), defined as ventricular dysfunction occurring within 24 hours after heart transplantation (HTx) in the absence of identifiable secondary causes, remains a major contributor to early post-transplant mortality. Over the past decade, there has been a growing understanding of the burden of PGD, the clinical relevance of PGD classification and severity grading, and efforts to identify donor-, recipient-, and procedural-related risk factors and biomarkers predictive of PGD. Significant advancements have been made in donor heart preservation and procurement technologies, as well as in utilization and outcomes of mechanical circulatory support for managing severe PGD patients. However, existing risk-stratification tools have limitations and perform poorly in predicting PGD in the contemporary era. In addition, prevention and management strategies of PGD remain variable, largely influenced by center-specific practices and the lack of objective data. Moreover, vasoplegia often co-exists with PGD, and their complex interplay remains incompletely understood. To address these gaps, a consensus conference was organized on April 9, 2024, endorsed by the International Society for Heart and Lung Transplantation. The conference represented a collaborative multidisciplinary effort by international experts in cardiothoracic transplantation to reassess the consensus definition and grading of PGD, established more than a decade ago, and provide guidance on the utility of risk stratification tools, potential strategies to mitigate the risk of PGD, and the efficacy of current treatment options. The nature of this consensus is to establish a foundation and pave the way for future studies. Findings and consensus statements are presented.</p>}},
  author       = {{Kobashigawa, Jon and Zuckermann, Andreas and Potena, Luciano and Ardehali, Abbas and Berman, Marius and Chang, Patricia P and Esmailian, Fardad and Farr, Maryjane and Hall, Shelley and Hsich, Eileen and Khush, Kiran and Kittleson, Michelle and Leprince, Pascal and Manla, Yosef and Martin-Suarez, Sofia and Moayedi, Yasbanoo and Segovia-Cubero, Javier and Shah, Ashish and Trahanas, John and MacDonald, Peter S and Nilsson, Johan}},
  issn         = {{1557-3117}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{Elsevier}},
  series       = {{The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation}},
  title        = {{Summary of the International Society for Heart and Lung Transplantation (ISHLT) Consensus Conference on Graft Dysfunction within the First 72 hours after Heart Transplantation : A 10-year Update}},
  url          = {{http://dx.doi.org/10.1016/j.healun.2025.12.029}},
  doi          = {{10.1016/j.healun.2025.12.029}},
  year         = {{2026}},
}