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Short lung transplant donor telomere length is associated with decreased CLAD-free survival
  1. Hilary E Faust1,2,
  2. Jeffrey A Golden2,
  3. Raja Rajalingam2,
  4. Angelia S Wang2,
  5. Gary Green2,
  6. Steven R Hays2,
  7. Jasleen Kukreja2,
  8. Jonathan P Singer2,
  9. Paul J Wolters2,
  10. John R Greenland2,3
  1. 1 Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  2. 2 University of California, San Francisco, California, USA
  3. 3 San Francisco VA Medical Center, San Francisco, California, USA
  1. Correspondence to Dr John R Greenland, San Francisco VA Medical Center, 4150 Clement St, San Francisco, CA 94121, USA; john.greenland{at}


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.

  • Lung Transplantation

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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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