ISHLT Consensus Statement on Short Telomere Syndrome and Lung Transplantation

Published 8 January 2026

Andrew Courtwright, MD, PhD; John Mackintosh; Jonathan Alder, PhD; Christine Kim Garcia, MD, PhD; Antoine Froidure, MD, PhD; Erin Lowery, MD, MS; Don Hayes, Jr., MD, MS, MEd, MBA; Pali Shah, MD; Quentin Philippot; Raphael Borie, MD, PhD; John Greenland, MD, PhD; Hannah Mannem, MD; Mark Snyder, MD; Merel Hellemons, MD, PhD; Laurie Snyder, MD, MHS; John McDyer, MD

J Heart Lung Transplant. January 2026.

• Advanced Lung Failure & Transplantation
• Consensus Document
• Publications & Journals
• Pulmonary Vascular Disease (PAH & CTEPH)
• Pulmonology
• Research & Immunology
• Standards & Guidelines

Motivated by growing evidence that the presence of critically shortened telomeres influences interstitial lung disease (ILD) trajectories, and is associated with extrapulmonary conditions relevant to transplant candidacy and post-transplant complications, this document is the result of work by an international writing committee with expertise in STS and is grounded in current literature and expert consensus.

This consensus document aims to address gaps in the evaluation and management of patients with STS, the need for this which arises from the recognition that STS is an underdiagnosed contributor to ILD, and that its presence introduces complexities that require dedicated, multidisciplinary attention in the transplant setting. Authors have included recommendations for screening, diagnosis, transplant risk stratification, peri- and post-transplant care, and research priorities in areas where substantial data are lacking.

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The ISHLT Perspective Piece is a new document type developed to accompany all ISHLT Documents and is specifically designed for print publication in JHLT. The piece The piece will set the context for the document in an easy-to-read manner and serves as an opportunity for writing groups to speak directly to the heart and lung transplant community about the rationale behind each document, its most important takeaways, and the hard work that went into creating it.

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