PMID- 23260706
OWN - NLM
STAT- MEDLINE
DCOM- 20130603
LR  - 20121224
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 32
IP  - 1
DP  - 2013 Jan
TI  - Donor-specific antibodies are associated with antibody-mediated rejection, acute 
      cellular rejection, bronchiolitis obliterans syndrome, and cystic fibrosis after 
      lung transplantation.
PG  - 70-7
LID - S1053-2498(12)01364-2 [pii]
LID - 10.1016/j.healun.2012.10.007 [doi]
AB  - BACKGROUND: Lung transplantation is limited by chronic lung allograft 
      dysfunction. Acute cellular rejection (ACR) is a risk factor for allograft 
      dysfunction; however, the role of antibody-mediated rejection (AMR) is not well 
      characterized. METHODS: This was a retrospective review from 2007 to 2011 of lung 
      transplant recipients with human leukocyte antigen (HLA) antibody testing using 
      Luminex (Luminex Corp, Austin, TX) single-antigen beads. Statistics included 
      Fisher's exact test for significance. RESULTS: Donor-specific antibodies (DSA) 
      developed in 13 of 44 patients. Of the 13 with DSA, 12 had cystic fibrosis 
      compared with 18 of 31 in the non-DSA group (p = 0.035). Of those with DSAs, 
      23.1% occurred within the first year, and 69.2% occurred between 1 and 3 years. 
      Twelve of 13 DSA patients had anti-HLA DQ specificity compared with 2 of 31 
      non-DSA patients (p = 0.0007). AMR developed in 10 of the 13 DSA patients 
      compared with 1 of 31 non-DSA patients (p = 0.0001). The DSA group experienced 
      2.6 episodes/patient of cellular rejection vs 1.7 episodes/patient in the non-DSA 
      group (p = 0.059). Bronchiolitis obliterans syndrome developed in 11 of 13 in the 
      DSA group vs 10 of 31 in the non-DSA group (p = 0.0024). In the DSA group, 11.5% 
      HLAs matched compared with 20.4% in the non-DSA group (p = 0.093). AMR developed 
      in 11 of 22 patients in the non-DSA HLA group compared with 0 of 22 in the group 
      without non-DSA HLA antibodies (p = 0.002). Survival at 1 and 3 years was 92% and 
      36% in the DSA group, respectively, and 97% and 65% in the non-DSA group. 
      CONCLUSIONS: DSAs and non-DSAs occur frequently after lung transplantation. DSAs 
      are prevalent in the cystic fibrosis population and are associated with AMR, 
      bronchiolitis obliterans syndrome, and possibly, ACR.
CI  - Copyright (c) 2013 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Lobo, Leonard J
AU  - Lobo LJ
AD  - University of North Carolina, Division of Pulmonary and Critical Care Medicine, 
      130 Mason Farm Rd, Campus Box 7020, Chapel Hill, NC 27599, USA. 
      leonardlobo@gmail.com
FAU - Aris, Robert M
AU  - Aris RM
FAU - Schmitz, John
AU  - Schmitz J
FAU - Neuringer, Isabel P
AU  - Neuringer IP
LA  - eng
PT  - Journal Article
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 (Antibodies)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibodies/*immunology
MH  - Bronchiolitis Obliterans/*immunology
MH  - Cystic Fibrosis/*immunology
MH  - Female
MH  - Graft Rejection/*immunology
MH  - Humans
MH  - Lung Transplantation/*adverse effects/*immunology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Tissue Donors
MH  - Young Adult
EDAT- 2012/12/25 06:00
MHDA- 2013/06/05 06:00
CRDT- 2012/12/25 06:00
PHST- 2012/06/01 00:00 [received]
PHST- 2012/09/26 00:00 [revised]
PHST- 2012/10/17 00:00 [accepted]
PHST- 2012/12/25 06:00 [entrez]
PHST- 2012/12/25 06:00 [pubmed]
PHST- 2013/06/05 06:00 [medline]
AID - S1053-2498(12)01364-2 [pii]
AID - 10.1016/j.healun.2012.10.007 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2013 Jan;32(1):70-7. doi: 10.1016/j.healun.2012.10.007.