Files and links (1)
Published, Version of Record (VoR)Open Access (License Unspecified), Open
Journal article
Quantitative Evidence for Revising the Definition of Primary Graft Dysfunction after Lung Transplant
American journal of respiratory and critical care medicine, v 197(2), pp 235-243
15 Jan 2018
PMID: 28872353
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Rationale: Primary graft dysfunction (PGD) is a form of acute lung injury that occurs after lung transplantation. The definition of PGD was standardized in 2005. Since that time, clinical practice has evolved, and this definition is increasingly used as a primary endpoint for clinical trials; therefore, validation is warranted.
Objectives: We sought to determine whether refinements to the 2005 consensus definition could further improve construct validity.
Methods: Data from the Lung Transplant Outcomes Group multicenter cohort were used to compare variations on the PGD definition, including alternate oxygenation thresholds, inclusion of additional severity groups, and effects of procedure type and mechanical ventilation. Convergent and divergent validity were compared for mortality prediction and concurrent lung injury biomarker discrimination.
Measurements and Main Results: A total of 1,179 subjects from 10 centers were enrolled from 2007 to 2012. Median length of follow-up was 4 years (interquartile range = 2.4-5.9). No mortality differences were noted between no PGD (grade 0) and mild PGD (grade 1). Significantly better mortality discrimination was evident for all definitions using later time points (48, 72, or 48-72 hours; P < 0.001). Biomarker divergent discrimination was superior when collapsing grades 0 and 1. Additional severity grades, use of mechanical ventilation, and transplant procedure type had minimal or no effect on mortality or biomarker discrimination.
Conclusions: The PGD consensus definition can be simplified by combining lower PGD grades. Construct validity of grading was present regardless of transplant procedure type or use of mechanical ventilation. Additional severity categories had minimal impact on mortality or biomarker discrimination.
Metrics
Details
- Title
- Quantitative Evidence for Revising the Definition of Primary Graft Dysfunction after Lung Transplant
- Creators
- Edward Cantu - University of PennsylvaniaJoshua M. Diamond - University of PennsylvaniaYoshikazu Suzuki - University of PennsylvaniaJared Lasky - University of PennsylvaniaChristian Schaufler - University of PennsylvaniaBrian Lim - University of PennsylvaniaRupal Shah - University of PennsylvaniaMary Porteous - University of PennsylvaniaDavid J. Lederer - Columbia UniversitySteven M. Kawut - University of PennsylvaniaScott M. Palmer - Duke UniversityLaurie D. Snyder - Duke UniversityMatthew G. Hartwig - Duke UniversityVibha N. Lama - University of Michigan–Ann ArborSangeeta Bhorade - University of ChicagoChristian Bermudez - University of PennsylvaniaMaria Crespo - University of PennsylvaniaJohn McDyer - University of PittsburghKeith Wille - University of Alabama at BirminghamJonathan Orens - Johns Hopkins UniversityPali D. Shah - Johns Hopkins UniversityAnn Weinacker - Stanford UniversityDavid Weill - University of South FloridaDavid Wilkes - University of IndianapolisDavid Roe - University of IndianapolisChadi Hage - University of IndianapolisLorraine B. Ware - Vanderbilt UniversityScarlett L. Bellamy - Drexel UniversityJason D. Christie - University of PennsylvaniaLung Transplant Outcomes Grp
- Publication Details
- American journal of respiratory and critical care medicine, v 197(2), pp 235-243
- Publisher
- Amer Thoracic Soc
- Number of pages
- 9
- Grant note
- AMFDP 70640 / Robert Wood Johnson grant R01HL096845 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) HL087115; HL081619; HL096845; HL115354; HL114626; HL121406; HL116656; HL126176; HL135227 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000422820200016
- Scopus ID
- 2-s2.0-85045220808
- Other Identifier
- 991019299006904721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Respiratory System