{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:46:10Z","timestamp":1792053970754,"version":"4.4.0"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":287,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Journal of Transplantation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The physiological relevance of postoperative perfusion distribution after single lung transplantation (SLT) remains poorly defined, as asymmetric blood flow toward the graft is often regarded as an inherent consequence of the remaining native lung. This study aimed to determine whether the graft\u2010directed perfusion ratio assessed by quantitative lung perfusion scintigraphy (QLPS) in the early postoperative period serves as an early physiological marker after SLT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed SLT recipients who underwent surgery at Okayama University Hospital between 1998 and 2021 and completed QLPS approximately 3\u2009months posttransplant. The graft perfusion ratio (graft flow\/total pulmonary flow \u00d7 100%) was quantified, and recipients were classified into high (\u2265\u200980%) and low (&lt;\u200980%) perfusion groups. CLAD\u2010free survival, overall survival, and longitudinal perfusion changes were compared using Kaplan\u2013Meier analysis and repeated\u2010measures ANOVA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Recipients with higher graft perfusion demonstrated significantly better CLAD\u2010free survival (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.027). Overall survival was higher in the high\u2010perfusion group, although the difference did not reach statistical significance (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.075). Repeated\u2010measures ANOVA revealed a significant group\u2010by\u2010time interaction (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.019): recipients who developed CLAD had lower graft perfusion as early as 3\u2009months after transplantation, followed by a progressive decline, whereas those who did not develop CLAD maintained stable perfusion. In the multivariable Cox analysis, higher graft perfusion was associated with a lower hazard of reaching the composite CLAD\u2010free survival endpoint.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early postoperative graft perfusion assessed by QLPS may serve as a noninvasive physiological marker after SLT. Higher graft\u2010directed perfusion was associated with a lower hazard of reaching the composite CLAD\u2010free survival endpoint and may aid early risk stratification and posttransplant surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/joot\/7647492","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:10:11Z","timestamp":1792051811000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Early Posttransplant Graft Perfusion and CLAD\u2010Free Survival After Single Lung Transplantation"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0014-9230","authenticated-orcid":false,"given":"Shin","family":"Tanaka","sequence":"first","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"},{"name":"Department of General Thoracic Surgery and Organ Transplant Center Okayama University Hospital  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery and Organ Transplant Center Okayama University Hospital  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7083-7066","authenticated-orcid":false,"given":"Yujiro","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery and Lung Transplantation Hospital Universitario Puerta de Hierro-Majadahonda  Madrid Spain  madrid.org"},{"name":"Surgery Department Medical School IDIPHISA Universidad Aut\u00f3noma de Madrid (UAM)  Madrid Spain  uam.es"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8975-3428","authenticated-orcid":false,"given":"Haruchika","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"},{"name":"Department of General Thoracic Surgery and Organ Transplant Center Okayama University Hospital  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumi","family":"Nakajima","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidejiro","family":"Torigoe","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1188-158X","authenticated-orcid":false,"given":"Shuji","family":"Okahara","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Resuscitology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4959-4220","authenticated-orcid":false,"given":"Kazuhiko","family":"Shien","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2463-9696","authenticated-orcid":false,"given":"Ken","family":"Suzawa","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1589-1216","authenticated-orcid":false,"given":"Kentaroh","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7202-244X","authenticated-orcid":false,"given":"Mikio","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6649-4777","authenticated-orcid":false,"given":"Seiichiro","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"},{"name":"Department of General Thoracic Surgery and Organ Transplant Center Okayama University Hospital  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7588-6745","authenticated-orcid":false,"given":"Shinichi","family":"Toyooka","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Breast, and Endocrinological Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan  okayama-u.ac.jp"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000004683"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.06.56"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.08.018"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2007.12.005"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14650"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivs066"},{"key":"e_1_2_9_7_2","first-page":"1771","article-title":"The Prognostic Value of Perfusion Lung Scintigraphy in Patients Who Underwent Single-Lung Transplantation for Emphysema and Pulmonary Fibrosis","volume":"41","author":"Hardoff R.","year":"2000","journal-title":"Journal of Nuclear Medicine"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000005189"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/txd.0000000000001189"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1172\/jci32311"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-67433-4"}],"container-title":["Journal of Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/joot\/7647492","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/joot\/7647492","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/joot\/7647492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:10:12Z","timestamp":1792051812000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/joot\/7647492"}},"subtitle":[],"editor":[{"given":"Richa","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/joot\/7647492"],"URL":"https:\/\/doi.org\/10.1155\/joot\/7647492","archive":["Portico"],"relation":{},"ISSN":["2090-0007","2090-0015"],"issn-type":[{"value":"2090-0007","type":"print"},{"value":"2090-0015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7647492"}}