PMID- 29529999 OWN - NLM STAT- MEDLINE DCOM- 20190422 LR - 20190422 IS - 1471-2466 (Electronic) IS - 1471-2466 (Linking) VI - 18 IP - 1 DP - 2018 Mar 12 TI - Prevalence of pre-transplant anti-HLA antibodies and their impact on outcomes in lung transplant recipients. PG - 45 LID - 10.1186/s12890-018-0606-8 [doi] LID - 45 AB - BACKGROUND: Previous studies have suggested that antibodies against human leukocyte antigen (HLA) are associated with worse outcomes in lung transplantation. However, little is known about the factors associated with outcomes following lung transplantation in Asia. Accordingly, we investigated the prevalence of anti-HLA antibodies in recipients before transplantation and assessed their impact on outcomes in Korea. METHODS: A single-center retrospective study was conducted. The study included 76 patients who received a lung transplant at a tertiary hospital in South Korea between January 2010 and March 2015. RESULTS: Nine patients (11.8%) had class I and/or class II panel-reactive antibodies greater than 50%. Twelve patients (15.8%) had anti-HLA antibodies with a low mean fluorescence intensity (MFI, 1000-3000), 7 (9.2%) with a moderate MFI (3000-5000), and 12 (15.8%) with a high MFI (> 5000). Ten patients (13.2%) had suspected donor-specific antibodies (DSA), and 60% (6/10) of these patients had antibodies with a high MFI. In an analysis of outcomes, high-grade (>/=2) primary graft dysfunction (PGD) was more frequent in patients with anti-HLA antibodies with moderate-to-high MFI values than in patients with low MFI values (39.4% vs. 14.0%, p = 0.011). Of 20 patients who survived longer than 2 years and evaluated for pBOS after transplant, potential bronchiolitis obliterans syndrome (pBOS) or BOS was more frequent in patients with anti-HLA antibodies with moderate-to-high MFI than in patients with low MFI, although this difference was not statistically significant (50.0% vs. 14.3%, p = 0.131). CONCLUSIONS: The prevalence of anti-HLA antibodies with high MFI was not high in Korea. However, the MFI was relatively high in patients with DSA. Anti-HLA antibodies with moderate-to-high MFI values were related to high-grade PGD. Therefore, recipients with high MFI before lung transplantation should be considered for desensitization and close monitoring. FAU - Park, Ji Eun AU - Park JE AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. AD - Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea. FAU - Kim, Chi Young AU - Kim CY AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. FAU - Park, Moo Suk AU - Park MS AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. FAU - Song, Joo Han AU - Song JH AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. FAU - Kim, Young Sam AU - Kim YS AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. FAU - Lee, Jin Gu AU - Lee JG AD - Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Paik, Hyo Chae AU - Paik HC AD - Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. FAU - Kim, Song Yee AU - Kim SY AD - Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Institute of Chest Diseases, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea. dobie@yuhs.ac. LA - eng PT - Journal Article DEP - 20180312 PL - England TA - BMC Pulm Med JT - BMC pulmonary medicine JID - 100968563 RN - 0 (Biomarkers) RN - 0 (HLA Antigens) RN - 0 (Isoantibodies) SB - IM MH - Adolescent MH - Adult MH - Aged MH - Biomarkers/blood MH - Bronchiolitis Obliterans/epidemiology MH - Female MH - Graft Rejection/*immunology/mortality MH - Graft Survival/immunology MH - HLA Antigens/*blood MH - Humans MH - Isoantibodies/*blood MH - Lung Transplantation/*mortality MH - Male MH - Middle Aged MH - Prevalence MH - Republic of Korea/epidemiology MH - Retrospective Studies MH - Risk Factors MH - Severity of Illness Index MH - Tissue Donors MH - Young Adult PMC - PMC5848509 OTO - NOTNLM OT - Anti-HLA antibodies OT - Donor-specific antibodies OT - Lung transplantation, Outcomes COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the Institutional Review Board (IRB) of Severance Hospital (IRB No. 4-2013-0770). Informed consent was waived because this was a retrospective study. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/03/14 06:00 MHDA- 2019/04/23 06:00 PMCR- 2018/03/12 CRDT- 2018/03/14 06:00 PHST- 2017/09/13 00:00 [received] PHST- 2018/03/01 00:00 [accepted] PHST- 2018/03/14 06:00 [entrez] PHST- 2018/03/14 06:00 [pubmed] PHST- 2019/04/23 06:00 [medline] PHST- 2018/03/12 00:00 [pmc-release] AID - 10.1186/s12890-018-0606-8 [pii] AID - 606 [pii] AID - 10.1186/s12890-018-0606-8 [doi] PST - epublish SO - BMC Pulm Med. 2018 Mar 12;18(1):45. doi: 10.1186/s12890-018-0606-8.