Risk factors for primary heart transplant dysfunction

Heart transplantation is the treatment of choice in case of identifying objective signs of severe chronic heart failure (CHF), refractory to drug therapy, inability to perform surgical reconstructive interventions due to their extremely high risk. Heart transplantations have been performed in the Republic of Belarus since 2009 and by the beginning of 2023, more than 500 such operations have been performed. The number of operations performed in the world is growing every year [1, 2].
The progress of high-tech medical care has improved survival after orthotopic heart transplantation (OHT) provided to patients with end-stage CHF over the past decade. Nowadays, the annual survival rate in the world is 90%, the five-year survival rate is equal to 75% [3].
Acute cellular and humoral rejection, infectious and surgical factors are the main causes of death among patients in the early period after OHT, but primary graft dysfunction (PGD) is the leading predictor of death. Nowadays, the hospital mortality of patients after OHT complicated by PGD stays extremely high and averages 30%. The frequency of primary graft dysfunction according to literature data ranges from 2.3% to 28.2%. Such a wide range of occurrence of this complication appears because of different approaches to diagnosis and criteria for diagnosis in various transplant centers [4].
The review article presents the criteria for the diagnosis of primary graft dysfunction, the classification of this condition and describes the main risk factors for the development of primary graft dysfunction on the part of both the donor and the recipient. Some results of our own research are presented in this article.

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