Segovia et al reported criteria primary graft failure (PGF) following heart transplantation. This is a leading cause of death within the first 30 days after heart transplant. The authors are from Hospital Universitario Puerta de Hierro in Madrid.
Patient selection: heart transplant recipient
Outcome: primary graft failure (PGF)
Criteria
Comments
significant myocardial dysfunction
impaired systolic function of one or both ventricles
severe hemodynamic impairment
(systolic blood pressure < 90 mm Hg) and/or (low cardiac output less than 2.2 L per min per square meter BSA) despite adequate filling pressures lasting for more than 1 hour
early onset after heart transplant
within 24 hours of heart transplantation
exclusion of secondary causes of graft dysfunction
hyperacute rejection, severe pulmonary hypertension, massive hemorrhage, technical problems durig surgery
where:
• The low cardiac output may require 2 or more intravenous inotropic/pressor agents or mechanical support (ventricular assist device, balloon pump).
All 4 criteria must be present for a diagnosis of PGF.
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