{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:54:10Z","timestamp":1791986050591,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"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:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary graft dysfunction (PGD) is the leading cause of early morbidity and mortality after lung transplantation (LTx). Critically ill candidates may receive priority on the transplant waiting list; however, the relationship between prioritization and the development of severe PGD remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of a prospectively maintained cohort including all consecutive LTx performed at a tertiary center between January 2016 and June 2025. Recipients were categorized according to prioritization status. Severe PGD was defined as grade 3 PGD according to the International Society for Heart and Lung Transplantation criteria. Clinical characteristics and outcomes were compared between prioritized and non\u2010prioritized recipients. Logistic regression was used to identify predictors of severe PGD, and survival was evaluated using Kaplan\u2013Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 310 LTx recipients, 74 (23.8%) were prioritized. They were younger, had a higher prevalence of pulmonary hypertension, and were more frequently hospitalized before transplantation, particularly in the intensive care unit. Severe PGD occurred more often among prioritized recipients (24%\u00a0vs 7%). However, prioritization was not independently associated with PGD after adjustment. Pre\u2010transplant extracorporeal membrane oxygenation support emerged as the strongest independent predictor of severe PGD. Thirty\u2010day mortality was similar between groups, whereas prioritized recipients had higher 90\u2010day and 1\u2010year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prioritized LTx recipients have greater pre\u2010transplant clinical severity, higher crude rates of severe PGD, and worse short\u2010term survival. However, prioritization itself was not independently associated with PGD, suggesting that underlying disease severity and need for advanced support are the main drivers of post\u2010transplant outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70711","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:43:06Z","timestamp":1791985386000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prioritization and Severe Primary Graft Dysfunction after Lung Transplantation"],"prefix":"10.1111","volume":"40","author":[{"given":"Fl\u00e1vio","family":"Pola dos Reis","sequence":"first","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Mestre","family":"Tejo","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Tropical Medicine Department Hospital Das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Lucas dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia Fiuza de Andrade","family":"Vale","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Arayama","family":"Cruz","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Gustavo","family":"Abdalla","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Vidal","family":"Campos","sequence":"additional","affiliation":[{"name":"Departamento De Pneumologia Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Matos","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Manuel","family":"P\u00eago\u2010Fernandes","sequence":"additional","affiliation":[{"name":"Departamento De Cirurgia Tor\u00e1cica Instituto Do Cora\u00e7\u00e3o do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2021.07.005"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.02.140"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2025.04.014"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26146776"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004503"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2022.10451"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595\u2010025\u201003129\u20104"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2024.10.045"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd\u201022\u2010974"},{"key":"e_1_2_14_11_1","unstructured":"Brasil. 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