Thabut et al listed the criteria for primary graft failure following lung transplantation. The authors are from multiple lung transplant centers in France.


Primary graft failure involves:

(1) reperfusion pulmonary edema

(2) may be accompanied by early hemodynamic failure (EHF)


Features of reperfusion noncardiogenic pulmonary edema:

(1) development of a radiographic infiltrate in the transplanted lung within 72 hours of the transplant

(2) PaO2 to FIO2 ratio < 300 within 72 hours of the transplant

(3) exclusion of other causes for the findings (pneumonia, ateletasis, heart failure, etc)


Early hemodynamic failure is defined as the need for catecholamine infusions to keep the mean arterial blood pressure (MABP) > 60 mm Hg.

Therapy Needed to Maintain MABP

Degree of EHF

dopamine dose 5.1 to 20 micrograms per kg per minute


epinephrine or norepinephrine (dopamine insufficient)



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