PMID- 29146602
OWN - NLM
STAT- MEDLINE
DCOM- 20180718
LR  - 20181029
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Linking)
VI  - 50
IP  - 5
DP  - 2017 Nov
TI  - Donor-specific and -nonspecific HLA antibodies and outcome post lung 
      transplantation.
LID - 1701248 [pii]
LID - 10.1183/13993003.01248-2017 [doi]
AB  - Donor-specific antibodies (DSAs) against human leukocyte antigen (HLA) are 
      associated with chronic lung allograft dysfunction (CLAD) and mortality post lung 
      transplantation, but data concerning prevalence, time of onset, persistence and 
      effects on long-term outcome remain scarce.We assessed the association between 
      HLA antibodies and CLAD-free and graft survival in a cohort of 362 patients. We 
      stratified our analysis according to DSA status, persistence of antibodies and 
      timing of antibodies (pre-transplant, early or late post-transplant).Within our 
      cohort, 61 (17%) patients developed DSAs (mostly against HLA-DQ), which was 
      associated with worse CLAD-free and graft survival (p<0.0001 and p=0.059, 
      respectively). Persistent (hazard ratio (HR) 3.386, 95% CI 1.928-5.948; p<0.0001) 
      as well as transient (HR 2.998, 95% CI 1.406-6.393; p=0.0045) DSAs were 
      associated with shorter CLAD-free survival compared with patients without DSAs. 
      Persistent DSAs (HR 3.071, 95% CI 1.632-5.778; p=0.0005) but not transient DSAs 
      were negatively associated with graft survival compared with patients without 
      DSAs, likely due to the higher incidence of restrictive CLAD. HLA non-DSAs and 
      pre-transplant HLA antibodies had no effect on post-transplant outcome.We 
      demonstrated an important difference in prognosis between persistent and 
      transient DSAs. Moreover, the observed association between DSAs and restrictive 
      CLAD suggests an overlap between antibody-mediated rejection and restrictive CLAD 
      that needs further investigation.
CI  - Copyright (c)ERS 2017.
FAU - Verleden, Stijn E
AU  - Verleden SE
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium stijn.verleden@med.kuleuven.be.
FAU - Vanaudenaerde, Bart M
AU  - Vanaudenaerde BM
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium.
FAU - Emonds, Marie-Paul
AU  - Emonds MP
AD  - HILA laboratory, Rode Kruis Vlaanderen, Mechelen, Belgium.
AD  - Dept of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
FAU - Van Raemdonck, Dirk E
AU  - Van Raemdonck DE
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium.
FAU - Neyrinck, Arne P
AU  - Neyrinck AP
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium.
FAU - Verleden, Geert M
AU  - Verleden GM
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium.
FAU - Vos, Robin
AU  - Vos R
AD  - Lung Transplant Unit, Division of Respiratory Disease, Dept of Clinical and 
      Experimental Medicine, KU Leuven, Leuven, Belgium.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171116
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
RN  - 0 (Biomarkers)
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Adult
MH  - Belgium
MH  - Biomarkers/blood
MH  - Female
MH  - Graft Survival
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Isoantibodies/*blood
MH  - *Lung Transplantation
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Time Factors
MH  - *Tissue Donors
COIS- Conflict of interest: None declared.
EDAT- 2017/11/18 06:00
MHDA- 2018/07/19 06:00
CRDT- 2017/11/18 06:00
PHST- 2017/06/23 00:00 [received]
PHST- 2017/08/11 00:00 [accepted]
PHST- 2017/11/18 06:00 [entrez]
PHST- 2017/11/18 06:00 [pubmed]
PHST- 2018/07/19 06:00 [medline]
AID - 50/5/1701248 [pii]
AID - 10.1183/13993003.01248-2017 [doi]
PST - epublish
SO  - Eur Respir J. 2017 Nov 16;50(5):1701248. doi: 10.1183/13993003.01248-2017. Print 
      2017 Nov.