{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:02:48Z","timestamp":1789365768149,"version":"build-2803163510"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>There is an urgent need to better understand the pathophysiology of primary graft dysfunction (PGD) to develop point-of-care methods predicting those at risk. We utilized a multiplex multivariable approach to define cytokines, chemokines, and growth factors in patient-matched biospecimens to identify factors predictive of PGD. Biospecimens were collected from patients undergoing bilateral lung transplantation (LTx) from three sites: donor lung perfusate, post-transplant bronchoalveolar lavage (BAL) fluid (2h), and plasma (2h, 24h, 72h, and 1 and 2\u00a0wks). A 71-multiplex panel was performed on each. Cross-validated logistic regression (LR) and random forest (RF) models determined whether analytes from each site, alone or combined with clinical data, discriminated PGD grade 0 (n = 9) vs. 3 (n = 8). BAL fluid at 2h was most predictive of PGD (LR, 0.825; RF, 0.919), followed by multi-timepoint plasma (LR, 0.841; RF, 0.653), then perfusate (LR, 0.565; RF, 0.448). Combined clinical, BAL, and plasma data yielded the strongest performance (LR, 1.000; RF, 1.000). BAL collected 2h post-transplant showed the strongest discriminatory signal for severe PGD in this exploratory cohort. This integrative approach identified IL-1RA, BCA-1, and Fractalkine as hypothesis-generating candidate biomarkers that warrant validation in larger independent studies.<\/jats:p>","DOI":"10.3389\/ti.2026.15874","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:10:12Z","timestamp":1789362612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-site cytokine levels are predictive of primary graft dysfunction following lung transplantation"],"prefix":"10.3389","volume":"39","author":[{"given":"Dianna","family":"Nord","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida","place":["Gainesville, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason Cory","family":"Brunson","sequence":"additional","affiliation":[{"name":"Laboratory for Systems Medicine, University of 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