AUTHOR=Novysedlak Rene , Vanluyten Cedric , Van Slambrouck Jan , Barbarossa Annalisa , Beeckmans Hanne , Van Raemdonck Dirk , De Leyn Paul , Van Veer Hans , Depypere Lieven , Jansen Yanina , Vanaudenaerde Bart M. , Vos Robin , Belmans Ann , Zajacova Andrea , Svorcova Monika , Vajter Jaromir , Tavandzis Janis , Pozniak Jiri , Simonek Jan , Ozaniak Strizova Zuzana , Vachtenheim Jiri , Lischke Robert , Ceulemans Laurens J. 
  
TITLE=Lower lung donor PaO2/FiO2 ratio correlates with early primary graft dysfunction, but does not impact overall survival after lung transplantation: a dual center study
  
JOURNAL=Transplant International
  
VOLUME=Volume 39 - 2026
  
YEAR=2026
  
URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2026.16414
  
DOI=10.3389/ti.2026.16414
  
ISSN=1432-2277
  
ABSTRACT=Extended criteria donor lungs falling below the arbitrarily set PaO2/FiO2 (PFR) threshold of 300 are frequently declined despite other acceptable parameters. This two-center retrospective analysis investigates whether donor PFR is a risk factor for outcomes after lung transplantation (LuTx). A retrospective cohort analysis was conducted at University Hospitals Leuven, Belgium and Motol University Hospital, Prague, Czech Republic including adult LuTx recipients from 2010 to 2022 (Leuven) and 2018–3/2023 (Prague). Primary endpoints: primary graft dysfunction (PGD) grade 3 at 24 and 72 h and 2‐year overall survival. Secondary endpoints: incidence of ACR and CLAD-free survival. Donor PFR was measured from an arterial blood gas sample. Logistic and Cox regression analyses were employed to assess correlations, while survival was analyzed using Kaplan-Meier estimates. A total of 984 LuTx recipients were included. Median follow-up was 4 years. Recipients were predominantly male (54%), with chronic obstructive pulmonary disease being the most common indication for transplantation. Donor characteristics included median age of 51 years, and 18% of donors were DCD. Analyses identified lower donor PFR as a risk factor for PGD grade 3 at 24 h, but not at 72 h. PFR was not associated with the incidence of ACR or with 2-year overall survival after LuTx. Donor PFR does not appear to be a risk factor for development of late PGD or for adversely impacting outcomes. However, it is associated with increased risk of early PGD.