Human Leukocyte Antigens Antibodies After Lung Transplantation: Primary Results of the HALT Study

Overview

Journal Am J Transplant

Publisher Elsevier

Specialty General Surgery

Date 2018 Apr 25

PMID 29687961

Citations 26

Authors

Ramsey R Hachem

Malek Kamoun

Marie M Budev

Medhat Askar

Vivek N Ahya

James C Lee

Deborah J Levine

Marilyn S Pollack

Gundeep S Dhillon

David Weill

Kenneth B Schechtman

Lorriana E Leard

Jeffrey A Golden

LeeAnn Baxter-Lowe

Thalachallour Mohanakumar

Dolly B Tyan

Roger D Yusen

Affiliations

Soon will be listed here.

Abstract

Donor-specific antibodies (DSA) to mismatched human leukocyte antigens (HLA) are associated with worse outcomes after lung transplantation. To determine the incidence and characteristics of DSA early after lung transplantation, we conducted a prospective multicenter observational study that used standardized treatment and testing protocols. Among 119 transplant recipients, 43 (36%) developed DSA: 6 (14%) developed DSA only to class I HLA, 23 (53%) developed DSA only to class II HLA, and 14 (33%) developed DSA to both class I and class II HLA. The median DSA mean fluorescence intensity (MFI) was 3197. We identified a significant association between the Lung Allocation Score and the development of DSA (HR = 1.02, 95% CI: 1.001-1.03, P = .047) and a significant association between DSA with an MFI ≥ 3000 and acute cellular rejection (ACR) grade ≥ A2 (HR = 2.11, 95% CI: 1.04-4.27, P = .039). However, we did not detect an association between DSA and survival. We conclude that DSA occur frequently early after lung transplantation, and most target class II HLA. DSA with an MFI ≥ 3000 have a significant association with ACR. Extended follow-up is necessary to determine the impact of DSA on other important outcomes.

Citing Articles

Efficacy of a Standardized Regimen of Therapeutic Plasma Exchange and IVIG for Treatment of Antibody-Mediated Rejection in Lung Transplant Recipients.

Wodajo A, Sarode R, De Simone N, Kaza V, Usmani A J Clin Apher. 2024; 39(6):e22151.

PMID: 39511735 PMC: 11579234. DOI: 10.1002/jca.22151.

Pushing the Survival Bar Higher: Two Decades of Innovation in Lung Transplantation.

Aburahma K, De Manna N, Kuehn C, Salman J, Greer M, Ius F J Clin Med. 2024; 13(18).

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Successfully physical therapy program for functional respiratory rehabilitation after lung transplant surgery - case report.

Tache-Codreanu D, David I, Popp C, Bobocea L, Traistaru M Rom J Morphol Embryol. 2024; 65(2):331-340.

PMID: 39020549 PMC: 11384042. DOI: 10.47162/RJME.65.2.21.

Management of donor-specific antibodies in lung transplantation.

Brandon W, Dunn C, Bollineni S, Joerns J, Lawrence A, Mohanka M Front Transplant. 2024; 2:1248284.

PMID: 38993917 PMC: 11235237. DOI: 10.3389/frtra.2023.1248284.

Editorial: Antibody-mediated rejection.

Hachem R, Mohanakumar T Front Transplant. 2024; 3:1408225.

PMID: 38993768 PMC: 11235309. DOI: 10.3389/frtra.2024.1408225.

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