PMID- 19134538
OWN - NLM
STAT- MEDLINE
DCOM- 20090515
LR  - 20161124
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 28
IP  - 1
DP  - 2009 Jan
TI  - Acute antibody-mediated rejection after lung transplantation.
PG  - 96-100
LID - 10.1016/j.healun.2008.09.013 [doi]
AB  - The role of humoral immunity after lung transplantation remains unclear. In this 
      report, we describe the pathologic findings and clinical course of a case of 
      acute antibody-mediated rejection (AMR) after lung transplantation. After an 
      uncomplicated early course, a 31-year-old man with cystic fibrosis developed 
      acute graft dysfunction 1 month after bilateral lung transplantation. Lung 
      biopsies showed acute pneumonitis with capillary injury, neutrophilic 
      infiltration and nuclear dust. Immunostaining for C4d demonstrated endothelial 
      cell deposition, and circulating donor-specific human leukocyte antigen (HLA) 
      antibodies were identified. Despite severe hypoxemic respiratory failure, he 
      responded well to a regimen consisting of methylprednisolone, plasma exchange, 
      intravenous immunoglobulin and rituximab therapy. He completely recovered 
      clinically although donor-specific HLA antibodies have remained detectable. The 
      incidence of acute AMR after lung transplantation is unknown, but this case 
      fulfills all of the consensus diagnostic criteria, and we suggest that AMR could 
      be an under-recognized cause of acute graft dysfunction.
FAU - Morrell, Matthew R
AU  - Morrell MR
AD  - Division of Pulmonary and Critical Care Medicine, Washington University School of 
      Medicine/Barnes-Jewish Hospital, St. Louis, Missouri, USA. mmorrell@im.wustl.edu
FAU - Patterson, G Alexander
AU  - Patterson GA
FAU - Trulock, Elbert P
AU  - Trulock EP
FAU - Hachem, Ramsey R
AU  - Hachem RR
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20081204
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Antilymphocyte Serum)
RN  - 0 (HLA Antigens)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Antibody Formation
MH  - Antilymphocyte Serum/therapeutic use
MH  - Bronchiectasis/complications/surgery
MH  - Cystic Fibrosis/*surgery
MH  - Forced Expiratory Volume
MH  - Graft Rejection/diagnostic imaging/*immunology/pathology/therapy
MH  - HLA Antigens/blood
MH  - Humans
MH  - Immunoglobulins, Intravenous/therapeutic use
MH  - Isoantibodies/*blood
MH  - Lung Transplantation/*immunology/pathology
MH  - Male
MH  - Plasma Exchange
MH  - Radiography, Thoracic
MH  - Treatment Outcome
EDAT- 2009/01/13 09:00
MHDA- 2009/05/16 09:00
CRDT- 2009/01/13 09:00
PHST- 2008/07/22 00:00 [received]
PHST- 2008/09/08 00:00 [revised]
PHST- 2008/09/29 00:00 [accepted]
PHST- 2009/01/13 09:00 [entrez]
PHST- 2009/01/13 09:00 [pubmed]
PHST- 2009/05/16 09:00 [medline]
AID - S1053-2498(08)00705-5 [pii]
AID - 10.1016/j.healun.2008.09.013 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2009 Jan;28(1):96-100. doi: 
      10.1016/j.healun.2008.09.013. Epub 2008 Dec 4.