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Bronchiolitis obliterans syndrome due to donor-specific HLA-antibodies.
Tissue Antigens 86, 178-185 (2015)
Chronic lung allograft dysfunction (CLAD) is a limiting factor for long-term survival in lung transplant recipients. Donor-specific human leukocyte antigen (HLA)-antibodies (DSA) have been suggested as potential risk factors for CLAD. However, their impact on clinical outcome following lung transplantation remains controversial. We performed a single-center study of 120 lung transplant recipients transplanted between 2006 and 2011. Patient sera were investigated before and after transplantation. The sera were screened by means of Luminex(®) technology (Luminex Inc., Austin, TX, USA) for IgG-HLA-class I and class II antibodies (ab). Using single antigen beads, DSA were identified and correlated retrospectively with clinical parameters. After transplantation 39 out of 120 patients (32.5%) were positive for HLA-ab. The incidence of de novo DSA formation was 27 of 120 patients (22.5%). Eleven of 27 (41%) of de novo DSA-positive patients developed BOS compared to 13 of 93 (14%) DSA-negative patients (p = 0.002). Furthermore, the generation of de novo DSA was independently associated with the development of BOS in multivariable analysis [hazard ration (HR) 2.5, 95% confidence interval (CI) 1.0-6.08; p = 0.046). Our results indicate that de novo DSA are associated with the development of BOS after lung transplantation. Monitoring of HLA-ab after transplantation is useful for identifying high-risk patients and offers an opportunity for early therapeutic intervention.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Bronchiolitis Obliterans Syndrome ; Chronic Lung Allograft Dysfunction ; Human Leukocyte Antigen-antibodies ; Humoral Rejection ; Lung Transplantation; Leukocyte Antigen Antibodies; Lung Allograft Dysfunction; Mediated Rejection; Clinical-relevance; Transplant Recipients; International-society; Organ-transplantation; Complement-binding; C4d Deposition; Luminex Assay
ISSN (print) / ISBN
0001-2815
e-ISSN
1399-0039
Zeitschrift
Tissue Antigens
Quellenangaben
Band: 86,
Heft: 3,
Seiten: 178-185
Verlag
Wiley
Verlagsort
Hoboken
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed