PMID- 23328795
OWN - NLM
STAT- MEDLINE
DCOM- 20130930
LR  - 20221109
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 144
IP  - 1
DP  - 2013 Jul
TI  - Implications for human leukocyte antigen antibodies after lung transplantation: a 
      10-year experience in 441 patients.
PG  - 226-233
LID - S0012-3692(13)60471-7 [pii]
LID - 10.1378/chest.12-0587 [doi]
AB  - BACKGROUND: Long-term survival after lung transplant is limited by the 
      development of chronic and progressive airflow obstruction, a condition known as 
      bronchiolitis obliterans syndrome (BOS). While prior studies strongly implicate 
      cellular rejection as a strong risk factor for BOS, less is known about the 
      clinical significance of human leukocyte antigen (HLA) antibodies and donor 
      HLA-specific antibodies in long-term outcomes. METHODS: A single-center cohort of 
      441 lung transplant recipients, spanning a 10-year period, was prospectively 
      screened for HLA antibodies after transplant using flow cytometry-based methods. 
      The prevalence of and predictors for HLA antibodies were determined. The impact 
      of HLA antibodies on survival after transplant and the development of BOS were 
      determined using Cox models. RESULTS: Of the 441 recipients, 139 (32%) had 
      detectable antibodies to HLA. Of these 139, 54 (39%) developed antibodies 
      specific to donor HLA. The detection of posttransplant HLA antibodies was 
      associated with BOS (HR, 1.54; P=.04) and death (HR, 1.53; P=.02) in 
      multivariable models. The detection of donor-specific HLA antibodies was 
      associated with death (HR, 2.42; P<.0001). The detection of posttransplant HLA 
      antibodies was associated with pretransplant HLA-antibody detection, platelet 
      transfusions, and the development of BOS and cytomegalovirus pneumonitis. 
      CONCLUSIONS: Approximately one-third of lung transplant recipients have 
      detectable HLA antibodies, which are associated with a worse prognosis regarding 
      graft function and patient survival.
FAU - Snyder, Laurie D
AU  - Snyder LD
AD  - Department of Medicine, Duke University, Durham, NC. Electronic address: 
      laurie.snyder@dm.duke.edu.
FAU - Wang, Ziwei
AU  - Wang Z
AD  - Department of Medicine, Duke University, Durham, NC.
FAU - Chen, Dong-Feng
AU  - Chen DF
AD  - Department of Pathology, Duke University, Durham, NC.
FAU - Reinsmoen, Nancy L
AU  - Reinsmoen NL
AD  - Department of Pediatrics and Medical Genetics Research Institute, Cedars-Sinai 
      Health Systems, Los Angeles, CA.
FAU - Finlen-Copeland, C Ashley
AU  - Finlen-Copeland CA
AD  - Department of Medicine, Duke University, Durham, NC.
FAU - Davis, W Austin
AU  - Davis WA
AD  - Department of Medicine, Duke University, Durham, NC.
FAU - Zaas, David W
AU  - Zaas DW
AD  - Department of Medicine, Duke University, Durham, NC.
FAU - Palmer, Scott M
AU  - Palmer SM
AD  - Department of Medicine, Duke University, Durham, NC.
LA  - eng
GR  - P50 HL084917/HL/NHLBI NIH HHS/United States
GR  - K24-091140-01/PHS HHS/United States
GR  - K24 HL091140/HL/NHLBI NIH HHS/United States
GR  - KL2RR024127/RR/NCRR NIH HHS/United States
GR  - KL2 RR024127/RR/NCRR NIH HHS/United States
GR  - 1P50-HL084917-01/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Antibodies)
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Antibodies/*blood
MH  - Biomarkers/blood
MH  - Bronchiolitis Obliterans/*epidemiology/*mortality
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Longitudinal Studies
MH  - Lung Transplantation/*immunology
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
PMC - PMC3707175
EDAT- 2013/01/19 06:00
MHDA- 2013/10/01 06:00
PMCR- 2014/07/01
CRDT- 2013/01/19 06:00
PHST- 2013/01/19 06:00 [entrez]
PHST- 2013/01/19 06:00 [pubmed]
PHST- 2013/10/01 06:00 [medline]
PHST- 2014/07/01 00:00 [pmc-release]
AID - S0012-3692(13)60471-7 [pii]
AID - chest.12-0587 [pii]
AID - 10.1378/chest.12-0587 [doi]
PST - ppublish
SO  - Chest. 2013 Jul;144(1):226-233. doi: 10.1378/chest.12-0587.