Background Heavy alcohol use is known to increase the risk of acute lung injury and the acute respiratory distress syndrome. since the donor history was taken by proxy. If the donor had no history of alcohol use the donor was considered ��donors had a history suggestive of heavy alcohol use according to NIAAA guidelines(Alcoholism 2005 and additional clinical evidence of alcohol abuse such as abnormally elevated alcohol biomarkers or abnormal liver biopsy. If there was insufficient or conflicting donor data available to accurately categorize the donor the patient was excluded from the AZD-9291 study. Table 1 Classification of Donor Alcohol History Clinical AZD-9291 Information Recipient charts were reviewed for transplant information survival days requiring mechanical ventilation partial pressure of arterial oxygen (PaO2) and fraction of inspired oxygen (FiO2) AZD-9291 at regular intervals following intensive care unit (ICU) AZD-9291 admission. Standard lung transplant protocols at our center included Perfadex? as the lung perfusate and FiO2 of 100% at time of reperfusion of the lung allograft. Arterial blood gases were checked per protocol including at the time of arrival to ICU (T0) and every 12 hours following while intubated and/or requiring fluctuating amounts of oxygen. PGD TM4SF4 was defined and graded according to standard International Society of Heart and Lung Transplant (ISHLT) guidelines (Christie et al. 2005 To be considered severe PGD the diagnosis was noted by the attending physician in the patient’s medical record following lung transplant. This then avoided other possible causes for AZD-9291 low PaO2 in the post-operative period such as intrathoracic bleeding or pneumonia from inadvertently being categorized as severe PGD. Standard maintenance immunosuppression regimen during the study period included a calcineurin inhibitor (tacrolimus) an antimetabolite (azathioprine or mycophenolate mofetil) and steroids. Patients routinely received induction immunosuppression with either basiliximab or dacluzamib during the study period with the exception of those patients seronegative for cytomegalovirus receiving an allograft from a cytomegalovirus seropositive donor. Statistical Analysis Standard descriptive statistics including medians and interquartile ranges (IQR) for continuous variables or frequencies and percents for categorical variables were used to describe clinical and demographic characteristics of the study population. Bivariate comparisons among donor alcohol groups were performed using Pearson’s ��2 for categorical variables and Kruskal-Wallis tests for continuous variables. Due to non-normal outcomes the more conservative Kruskal-Wallis test was used; however one-way ANOVA results did not differ appreciably and are not presented. Bonferroni adjusted pairwise comparisons for significant Kruskal-Wallis tests were conducted using Wilcoxon Rank Sum tests. Multivariate logistic regression was then performed to assess the effect of donor alcohol use on risk of PGD while controlling for potential confounding variables known to be independent risk factors for PGD including use of cardiopulmonary bypass a pulmonary diagnosis of pulmonary hypertension or sarcoidosis AZD-9291 body mass index (BMI) any smoking use in the donor recipient of single lung transplant and ischemic time (Diamond et al. 2013 Severe PGD in the multivariate logistic regression model was defined by persistence of PGD grade 3 at 48 or 72 hours according to the ISHLT criteria (Christie et al. 2005 and noted in the patient chart. Survival estimates and freedom from mechanical ventilation were obtained utilizing Kaplan Meier survival curves and assessed with a log-rank value. Statistical significance was considered relevant with a group compared to the group [29 (IQR: 24-43) versus 25 (IQR: 18-37) and the groups was not statistically significant (group with 73% male versus 63% male in versus 43% in group compared to the groups group compared to the group with the median ratio being 2.25 (IQR: 1.09-2.96) in those with group group compared to the group group at 27.1 (IQR: 24.5-30.7) compared to the group 23.7 (IQR: 20.5-27.4) and the group 25.07 (IQR: 21.8-26.9) group 45.7% compared to the other groups with 55.1% male recipients in the and 53.5% in the group. There were no significant differences in lung allocation score (LAS) ischemic time of the lung allograft between groups and.