Telomere length (TL) decreases with cellular ageing and biological stressors. As advanced donor and recipient ages are risk factors for chronic lung allograft dysfunction (CLAD), we hypothesised that decreased age-adjusted donor TL would predict earlier onset of CLAD. Shorter donor TL was associated with increased risk of CLAD or death (HR 1.26 per 1 kb TL decrease, 95% CI 1.03 to 1.54), particularly for young donors. Recipient TL was associated with cytopenias but not CLAD. Shorter TL was also seen in airway epithelium for subjects progressing to CLAD (p=0.02). Allograft TL may contribute to CLAD pathogenesis and facilitate risk stratification.
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Contributors HEF, JRG, JAG and PJW designed the experiments. JAG, RR, SRH, JK and JPS recruited subjects and contributed to sample collection and maintenance. HEF, GG and ASW performed the experiments. HEF and JRG analysed data and wrote the manuscript. All authors read and approved the manuscript.
Funding This work was supported by the OneLegacy foundation (JRG), the Nina Ireland Program for Lung Health (JRG, PJW), VA grant 1IK2CX001034-01A2 (JRG), the National Heart, Lung and Blood Institute grants P01HL108794 (PJW) and 5T32HL007185-37 (HEF).
Competing interests None declared.
Ethics approval UCSF Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
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