High-Risk HLA-DQ Mismatches Are Associated With Adverse Outcomes After Lung Transplantation.

Autor:	Kleid L; Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany., Walter J; Division of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany.; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany.; Department of Medicine V, LMU Munich University Hospital, Munich, Germany., Moehnle P; Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany., Wichmann C; Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany., Kovács J; Division of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany.; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany., Humpe A; Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany., Schneider C; Division of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany.; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany., Michel S; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany.; Department of Cardiac Surgery, University Hospital, LMU Munich, Munich, Germany., Kneidinger N; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany.; Department of Medicine V, LMU Munich University Hospital, Munich, Germany.; Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria., Irlbeck M; Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany., Fertmann J; Division of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany.; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany., Dick A; Division of Transfusion Medicine, Cell Therapeutics and Haemostaseology, University Hospital, LMU Munich, Munich, Germany., Kauke T; Division of Thoracic Surgery, University Hospital, LMU Munich, Munich, Germany.; Comprehensive Pneumology Center (CPC), Helmholtz Munich, Member of the German Center of Lung Research (DZL), LMU Munich, Munich, Germany.; Transplantation Center Munich, LMU Munich University Hospital, Munich, Germany.
Jazyk:	angličtina
Zdroj:	Transplant international : official journal of the European Society for Organ Transplantation [Transpl Int] 2024 Sep 19; Vol. 37, pp. 13010. Date of Electronic Publication: 2024 Sep 19 (Print Publication: 2024).
DOI:	10.3389/ti.2024.13010
Abstrakt:	Human leukocyte antigen (HLA) mismatches (MM) between donor and recipient lead to eplet MM (epMM) in lung transplantation (LTX), which can induce the development of de-novo donor-specific HLA-antibodies (dnDSA), particularly HLA-DQ-dnDSA. Aim of our study was to identify risk factors for HLA-DQ-dnDSA development. We included all patients undergoing LTX between 2012 and 2020. All recipients/donors were typed for HLA 11-loci. Development of dnDSA was monitored 1-year post-LTX. EpMM were calculated using HLAMatchmaker. Differences in proportions and means were compared using Chi2-test and Students' t-test. We used Kaplan-Meier curves with LogRank test and multivariate Cox regression to compare acute cellular rejection (ACR), chronic lung allograft dysfunction (CLAD) and survival. Out of 183 patients, 22.9% patients developed HLA-DQ-dnDSA. HLA-DQ-homozygous patients were more likely to develop HLA-DQ-dnDSA than HLA-DQ-heterozygous patients ( p = 0.03). Patients homozygous for HLA-DQ1 appeared to have a higher risk of developing HLA-DQ-dnDSA if they received a donor with HLA-DQB1*03:01. Several DQ-eplets were significantly associated with HLA-DQ-dnDSA development. In the multivariate analysis HLA-DQ-dnDSA was significantly associated with ACR ( p = 0.03) and CLAD ( p = 0.01). HLA-DQ-homozygosity, several high-risk DQ combinations and high-risk epMM result in a higher risk for HLA-DQ-dnDSA development which negatively impact clinical outcomes. Implementation in clinical practice could improve immunological compatibility and graft outcomes. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Kleid, Walter, Moehnle, Wichmann, Kovács, Humpe, Schneider, Michel, Kneidinger, Irlbeck, Fertmann, Dick and Kauke.)
Databáze:	MEDLINE
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