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Acute Allograft Failure in Thoracic Organ Transplantation
Author(s) -
Jahania M. Salik,
Mullett Timothy W.,
Sanchez Juan A.,
Narayan Prakash,
Lasley Robert D.,
Mentzer Robert M.
Publication year - 2000
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2000.tb00451.x
Subject(s) - elephant trunks , medicine , dissection (medical) , trunk , surgery , anastomosis , arch , aortic dissection , aorta , ecology , civil engineering , engineering , biology
A bstract Thoracic organ transplantation is an effective form of treatment for end‐stage heart and lung disease. Despite major advances in the field, transplant patients remain at risk for acute allograft dysfunction, a major cause of early and late mortality. The most common causes of allograft failure include primary graft failure secondary to inadequate heart and lung preservation during cold storage, cellular rejection, and various donor‐recipient‐related factors. During cold storage and early reperfusion, heart and lung allografts are vulnerable to intracellular calcium overload, acidosis, cell swelling, injury mediated by reactive oxygen species, and the inflammatory response. Brain death itself is associated with a reduction in myocardial contractility, and recipient‐related factors such as preexisting pulmonary hypertension can lead to acute right heart failure and the pulmonary reimplantation response. The development of new methods to prevent or treat these various causes of acute graft failure could lead to a marked improvement in short‐ and long‐term survival of patients undergoing thoracic organ transplantation.