{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:00:23Z","timestamp":1790618423253,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Respiratory cultures before and after lung transplantation are frequently obtained but often difficult to interpret. A positive culture may represent donor\u2010derived organisms, recipient reservoir recolonization, hospital acquisition, transient colonization, invasive infection, or a marker of evolving graft vulnerability. This review summarizes how respiratory microbiology changes across the lung transplant timeline and proposes a practical framework for clinical interpretation. Conventional culture\u2010based studies and recent airway microbiome literature are integrated to examine donor\u2010recipient attribution, pre\u2010transplant colonization, disease\u2010specific reservoirs, single\u2010lung transplantation, and pathogen\u2010specific risk. Pre\u2010transplant recipient colonization, particularly with multidrug\u2010resistant gram\u2010negative organisms, appears more consistently associated with early post\u2010transplant pneumonia and short\u2010term outcomes than donor culture positivity alone when targeted antimicrobial therapy is used. Disease\u2010specific patterns are also important: cystic fibrosis and bronchiectasis favor recolonization from persistent reservoirs, whereas single\u2010lung transplantation creates a dual\u2010airway ecosystem in which the native lung may remain microbiologically relevant. Persistent or recurrent isolation of organisms such as\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    ,\n                    <jats:italic>Burkholderia cenocepacia<\/jats:italic>\n                    ,\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    ,\n                    <jats:italic>Aspergillus<\/jats:italic>\n                    species, and nontuberculous mycobacteria should be interpreted in relation to symptoms, imaging, lung function, sampling source, and timing from transplant. Contextual interpretation of respiratory cultures may improve antimicrobial planning, donor acceptance decisions, stewardship, and long\u2010term graft surveillance.\n                  <\/jats:p>","DOI":"10.1111\/ctr.70702","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:46:51Z","timestamp":1790617611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Microbiological Dynamics Before and After Lung Transplantation: Clinical Interpretation and Prognostic Implications"],"prefix":"10.1111","volume":"40","author":[{"given":"Takashi","family":"Hirama","sequence":"first","affiliation":[{"name":"Division of Organ Transplantation Tohoku University Hospital  Sendai Japan"},{"name":"Department of Thoracic Surgery, Institute of Development, Aging and Cancer Tohoku University  Sendai 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