Persistence of de novo donor specific HLA-Antibodies after lung transplantation: a potential marker of decreased patient survival
| Autor: | Georgios Meimarakis, Laura V. Klotz, Teresa Kauke, Andrea Dick, N Strobl, C Schneider, V. von Dossow, Gerhard Preissler, Nikolaus Kneidinger, M Schmitzer, Harland S. Winter, RA Hatz, Thomas Weig, René Schramm |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Immunology 030230 surgery Gastroenterology Persistence (computer science) 03 medical and health sciences 0302 clinical medicine Internal medicine Genetics medicine Immunology and Allergy Lung transplantation Clinical significance Hla antibodies Stage (cooking) Lung biology business.industry body regions Transplantation medicine.anatomical_structure biology.protein 030211 gastroenterology & hepatology Antibody business |
| Zdroj: | HLA. |
| ISSN: | 2059-2310 |
| Popis: | The impact of de novo donor-specific anti-HLA antibodies (DSA) on outcomes in lung transplantation is still a matter of debate. We hypothesize that differentiating DSA by persistent and transient appearance may offer an additional risk assessment. The clinical relevance of HLA-antibodies was investigated prospectively in 72 recipients with a median follow-up period of 21 months. The presence of HLA-antibodies was analysed by single antigen bead assay prior to and after (3 weeks, 3, 6, 12 and 18 months) transplantation. In 23 patients (32%) de novo DSA were detected. In 10 of these patients (44%) DSA persisted throughout the follow-up period whereas 13 of these patients (56%) had transient DSA. There was a trend towards lower one-year-survival in DSA positive compared to DSA negative patients (83% versus 94%; p=0.199). Remarkably, patients with persistent DSA had significantly reduced survival (one-year survival 60%) compared with both patients without DSA and those with transient DSA (p=0.005). Persistent DSA represented an independent prognostic factor for reduced overall survival in multivariate analysis (HR 8.3, 95% CI 1.8-37.0; p=0.006). Persistence of DSA during the first year after transplantation seems to be more harmful for lung allograft function than transiently detected DSA at an early stage. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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