Inherent recipient factors, including pre-transplant diagnosis, obesity, and elevated pulmonary pressures are established PGD risks. We evaluated the relationship between pre-operative lung injury biomarkers and PGD to gain further mechanistic insight in recipients. We performed a prospective cohort study of recipients in the lung transplant outcomes group enrolled between 2002 and 2010. Our primary outcome was grade 3 PGD on day 2 or 3. We measured pre-operative plasma levels of 5 biomarkers (CC-16, sRAGE, ICAM-1, IL-8, and Protein C) that were previously associated with PGD when measured at the post-operative timepoint. We used multivariable logistic regression to adjust for potential confounders. Of 714 subjects, 130 (18%) developed PGD. Median CC-16 levels were elevated in subjects with PGD (10.1 vs. 6.0, p