Idiopathic pulmonary fibrosis (IPF) is a fatal and chronically progressive diffuse parenchymal lung disease that is characterized by varying degrees of fi brosis of the lung parenchyma. 1 Currently, there are few proven, standardized therapies for IPF 2 ; the only viable treatment that has shown survival benefi t for patients with advanced stages of IPF is lung transplantation. [3][4][5][6][7] Nonetheless, the survival benefi t for lung transplantation in patients with IPF is still complicated by signifi cant early mortality rates, especially within the fi rst year (approximately 28%). The 10-year survival rate after lung transplantation is worse for patients with IPF when compared with other diseases, such as idiopathic pulmonary arterial hypertension (PAH), cystic fi brosis, and a 1 -antitrypsin-defi ciency emphysema. 8 Elevated mean pulmonary arterial pressure (mPAP) in patients with IPF has been associated with decreased exercise capacity and worse survival. 9 Higher mPAP was also associated with increased mortality following lung transplantation in a large registry study. 10 One possible explanation for the link between PAH and early mortality after lung transplantation