Swaminathan AC, et al. - In this investigation, researchers desired to know whether patients with pulmonary fibrosis (PF), the most common disease indication for lung transplantation, -associated variants (TERT, RTEL1, or PARN) have altered rates of post-transplant acute rejection (AR), chronic lung allograft dysfunction (CLAD), and survival. Study participants included 262 PF lung transplant recipients previously genetically characterized by whole exome sequencing. Thirty-one patients (31/262, 11.8%) had variants in TERT, RTEL1, or PARN whereas 231 (231/262, 88.2%) did not have variants. To evaluate the outcomes of death and CLAD, Multivariate Cox proportional hazards models adjusted for relevant clinical variables were utilized. Among PF lung transplant recipients, rare variants in the telomere-related genes TERT, RTEL1, or PARN are related to poor post-transplant results.