Guidelines for the diagnosis and management of primary graft dysfunction after lung transplantation

doi:10.3877/cma.j.issn.1674-3903.2026.01.002

Abstract

Abstract:

Primary graft dysfunction (PGD) is the most common and challenging early complication after lung transplantation, with a profound impact on both short- and long-term outcomes. To standardize and optimize the diagnosis and management of PGD and improve the prognosis of lung transplant recipients, the Lung Transplantation Group, Chinese Society of Organ Transplantation, Chinese Medical Association and China Quality Management and Control Center for Lung Transplantation convened a multidisciplinary working group. This group comprised experts from lung transplantation, intensive care medicine, respiratory and critical care medicine, cardiothoracic surgery and rehabilitation medicine. Drawing on recent evidence-based findings and the clinical practice experience of lung transplantation in China, the group developed the Guidelines for the Diagnosis and Management of Primary Graft Dysfunction After Lung Transplantation. The guideline addresses risk factors, diagnostic criteria, therapeutic strategies and prognosis of PGD, and provides a series of scientifically sound and standardized recommendations aimed at optimizing the comprehensive management of PGD in China.

Key words: Lung transplantation, Primary graft dysfunction, Clinical guidelines, Management heterogeneity, Prognosis

Lung Transplantation Group, Chinese Society of Organ Transplantation, Chinese Medical Association, China Quality Management and Control Center for Lung Transplantation. Guidelines for the diagnosis and management of primary graft dysfunction after lung transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2026, 20(01): 15-26.

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URL: https://zhyzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3903.2026.01.002

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References 103

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推荐强度	证据级别	描述
A	1a	RCTs的系统评价
	1b	结果可信区间小的RCT
	1c	显示"全或无效应"的任何证据
B	2a	队列研究的系统评价
	2b	单个的队列研究(包括低质量的RCT，如失访率>20%)
	2c	基于患者结局的研究
	3a	病例对照研究的系统评价
	3b	单个病例对照研究
C	4	病例系列报告、低质量队列研究和低质量病例对照研究
D	5	专家意见(即无临床研究支持的仅依据基础研究或临床经验的推测)

推荐强度	证据级别	描述
A	1a	RCTs的系统评价
	1b	结果可信区间小的RCT
	1c	显示"全或无效应"的任何证据
B	2a	队列研究的系统评价
	2b	单个的队列研究(包括低质量的RCT，如失访率>20%)
	2c	基于患者结局的研究
	3a	病例对照研究的系统评价
	3b	单个病例对照研究
C	4	病例系列报告、低质量队列研究和低质量病例对照研究
D	5	专家意见(即无临床研究支持的仅依据基础研究或临床经验的推测)

PGD分级	氧合指数(mmHg)	胸部X线表现	体外生命支持
0	任何	正常	无
1	> 300	弥漫性异体移植物浸润/肺水肿	无
2	200~300	弥漫性异体移植物浸润/肺水肿	无
3	< 200	弥漫性异体移植物浸润/肺水肿	无
3	－	弥漫性异体移植物浸润/肺水肿	有
无法分级	－	正常	有

PGD分级	氧合指数(mmHg)	胸部X线表现	体外生命支持
0	任何	正常	无
1	> 300	弥漫性异体移植物浸润/肺水肿	无
2	200~300	弥漫性异体移植物浸润/肺水肿	无
3	< 200	弥漫性异体移植物浸润/肺水肿	无
3	－	弥漫性异体移植物浸润/肺水肿	有
无法分级	－	正常	有

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