Impact of Telomere Shortening on Post-transplant Outcomes in Interstitial Lung Disease

Shortened telomere length (STL) is associated with increased rates of interstitial lung diseases, malignancy, hematological disorders, and immunosuppressive treatment toxicities. In this single-center retrospective study, we aim to determine whether patients with interstitial lung diseases who have STL, as determined by quantitative PCR of buccal epithelial cells, exhibit worse post-transplant outcomes compared to recipients with normal telomere length. In our series of 26 patients, STL was associated with a higher incidence of chronic kidney disease following lung transplantation (100% vs 55%, P = .042). However, STL was not associated with an increased incidence of acute cellular rejection, infections, cytomegalovirus viremia, cytopenias, elevated liver enzymes, cancer diagnosis, venous thromboembolism, or mortality. Thus, lung transplant recipients with STL are at an increased risk of developing chronic kidney disease during the post-transplant period compared to those with normal telomere length.