Summary of the ISHLT Consensus Conference on Graft Dysfunction within the First 72 hours after Heart Transplantation: A 10-year Update

Published 13 March 2026

Jon Kobashigawa, MD; Andreas Zuckermann, MD; Luciano Potena, MD, PhD; Abbas Ardehalis, MD; Marius Berman, MD; Patricia Chang, MD, MHS; Fardad Esmailian, MD; Maryjane Farr, MD, MSc; Shelley Hall, MD; Eileen Hsich, MD; Kiran Khush, MD, MAS; Michelle Kittleson, MD, PhD; Pascal Leprince, MD, PhD; Yosef Manla, MD; Sofia Martin-Suarez, MD, PhD; Yasbanoo Moayedi, MD, MHSc; Javier Segocia-Cubero, MD, PhD; Ashish Shah, MD; John Trahanas, MD; Peter MacDonald, MD, PhD; on behalf of the Consensus Conference Participatns

J Heart Lung Transplant. March 2026.

  • Advanced Heart Failure & Transplantation
  • Cardiology
  • Cardiothoracic Surgery
  • Consensus Document
  • Publications & Journals
  • Standards & Guidelines

Over the past decade, there has been a growing understanding of primary graft dysfunction incidence, presentation, risk factors, biomarkers, potential underlying pathophysiology, and prevention, including the use of advanced organ procurement and preservation technologies, management strategies, and outcomes. However, current practices remain variable, attributable to a lack of objective data and largely influenced by center-specific practices.

The 2024 ISHLT Consensus Conference on Primary Graft Dysfunction took place in Prague on 9 April, 2024, and was designed to provide a forum for in-depth discussions among leading experts in the field, and represented a collaborative multidisciplinary effort by experts in cardiac transplantation worldwide to update current definitions and classifications of graft dysfunction, enrich the heart transplant community understanding of its risk factors and biomarkers, delve into potential prevention and management strategies, and unwind primary graft dysfunction overlap with vasoplegia.

This resulting document aims to provide a more standardized pathway for the prevention, diagnosis, and management of graft dysfunction after heart transplantation and pave the way for future studies.

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The ISHLT Perspective Piece is a new document type developed to accompany all ISHLT Documents and is specifically designed for print publication in JHLT. The piece The piece will set the context for the document in an easy-to-read manner and serves as an opportunity for writing groups to speak directly to the heart and lung transplant community about the rationale behind each document, its most important takeaways, and the hard work that went into creating it.

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