The hypothesis introduced by the authors was that distinct phenotypes of PGD are associated with different prognoses identified by latent class analysis. However, the results may be produced by the evolution of PGD per se and the risk factors for exacerbation of PGD rather than by the distinct phenotypes. By analogy, it is not difficult to recognize that individuals with the same stage of non-small cell lung cancer often have disparate manifestations of the disease and different prognoses. The authors compared different characteristics among classes in the three-class model to identify risk factors for severe PGD. However, if all the factors were included in multivariable logistic regression, independent risk factors for PGD may be discriminated from those presented by the authors (donor age, donor smoking, donor mode of death, cardiopulmonary bypass, intraoperative crystalloids, tidal volume, packed RBC use, pulmonary artery pressure). Previous studies have demonstrated more risk factors, including Fio2 during allograft reperfusion, single lung transplant, recipient BMI indicating overweight or obesity, preoperative sarcoidosis, or pulmonary arterial hypertension2 and black donors and female donors.3 PGD was a significant predictor for lung transplant outcomes. Thus, patients could benefit from preventive strategies aimed at reducing reperfusion injury and decreasing the hazardness of risk factors for PGD.