137: Pre-transplant MICA, HLA class I or II antibodies are associated with earlier onset of bronchiolitis obliterans syndrome in lung transplant recipient

Lyu, D.M.; Nicolls, M.; Freed, Brian M.; Cagle, Linda; Zamora, Martin R.

doi:10.1016/j.healun.2006.11.153

Cited by 7 publications

(9 citation statements)

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“…Pre‐formed DSA, particularly complement‐fixing DSA, and high MFI have been shown to be associated with poor survival within the first year of lung transplantation . One other study confirmed an association of pre‐transplant HLA‐antibodies with an early onset of BOS following lung transplantation but they could not find a correlation between HLA‐antibodies and acute cellular rejection or overall survival . In our cohort patients with preformed HLA‐antibodies both DSA and non‐DSA had favorable graft function.…”

Section: Discussionmentioning

confidence: 46%

Bronchiolitis obliterans syndrome due to donor‐specific HLA‐antibodies

et al. 2015

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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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Section: Discussionmentioning

confidence: 46%

Bronchiolitis obliterans syndrome due to donor‐specific HLA‐antibodies

et al. 2015

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“…Firstly, antibodies to MHC class I-related chain A, expressed on endothelial cells and monocytes, have been associated with increased graft failure after kidney transplantation [68]. Likewise, LYU et al [69] and ANGASWAMY et al…”

Section: Autoimmunitymentioning

confidence: 99%

Immune processes in the pathogenesis of chronic lung allograft dysfunction: identifying the missing pieces of the puzzle

et al. 2022

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Lung transplantation is the optimal treatment for selected patients with end-stage chronic lung diseases. However, chronic lung allograft dysfunction remains the leading obstacle to improved long-term outcomes. Traditionally, lung allograft rejection has been considered primarily as a manifestation of cellular immune responses. However, in reality, an array of complex, interacting and multifactorial mechanisms contribute to its emergence. Alloimmune-dependent mechanisms, including T-cell-mediated rejection and antibody-mediated rejection, as well as non-alloimmune injuries, have been implicated. Moreover, a role has emerged for autoimmune responses to lung self-antigens in the development of chronic graft injury. The aim of this review is to summarise the immune processes involved in the pathogenesis of chronic lung allograft dysfunction, with advanced insights into the role of innate immune pathways and crosstalk between innate and adaptive immunity, and to identify gaps in current knowledge.

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“…However, the largest experience, from the International Society for Heart and Lung Transplant (ISHLT) registry, reports that 48% of recipients develop BOS by five years after lung transplant and 76% develop BOS after ten years. 29 Risk factors for BOS are manyfold. Besides viral infections, other factors that increase BOS risk include episodes of acute immune-mediated organ rejection, bacterial and fungal colonisation, primary graft dysfunction and gastroesophageal reflux disease.…”

Section: Bronchiolitis Obliterans Syndromementioning

confidence: 99%