One in five lung recipients has severe early graft dysfunction.
Primary graft dysfunction at 72 hours is the leading cause of early death after lung transplant — and VitalMatch's model target. Derived here from the ISHLT grade-3 definition, its incidence is high, rising, and tracks donor factors knowable at the moment of offer.
Source: OPTN/UNOS STAR file, Dec 2025 release · bilateral lung recipients (one per donor). Severe PGD@72h = P/F < 200 or on ECMO at 72 h (ISHLT grade-3 proxy); labelled for 23,752 recipients.
20%
19.5% of bilateral lung recipients meet severe PGD@72h (4,630 of 23,752). It splits about evenly between the two mechanisms — P/F < 200 (12%) and ECMO support (10%).
01 · Trajectory
Incidence is high and drifting up
Severe PGD@72h by transplant year — consistent with the rising use of marginal donors and longer ischemic times documented in the other briefs.
Severe PGD@72h incidence (%)
02 · Offer-time risk factors
The drivers are knowable before you accept
PGD rises monotonically with cold-ischemia time and with donor risk (DCD, older age) — all observable at the moment of the organ offer, which is what makes it a tractable prediction target.
By ischemic time
By donor age & type
This is the target VitalMatch predicts. Every driver above — ischemia, donor age, DCD — is an offer-time variable, and donor-lung CT adds the organ-quality read the tabular fields miss. A calibrated PGD@72h risk at the moment of offer is decision support exactly where PGD originates.