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Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study.

Publication ,  Journal Article
Hadjiliadis, D; Chaparro, C; Reinsmoen, NL; Gutierrez, C; Singer, LG; Steele, MP; Waddell, TK; Davis, RD; Hutcheon, MA; Palmer, SM; Keshavjee, S
Published in: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
July 2005

BACKGROUND: The presence of antibodies to human leukocyte antigens (HLA) prior to transplantation has been linked to worse post-transplant outcomes in many solid organ transplants. The effect of these antibodies is less clear in lung transplant recipients, although previous studies have suggested an increased incidence of allograft dysfunction. METHODS: A retrospective study of all first lung transplant recipients from the University of Toronto (November 1983-July 2001, n = 380) and Duke University (April 1992-June 2000, n = 276) was performed. Demographic data, survival information, and level of last pre-transplant panel reactive antibody (PRA) were collected. PRA level was measured by the complement-dependent cell cytotoxicity assay at both centers. Survival analysis was performed using the Kaplan-Meier method, and groups were compared with the Wilcoxon rank sum test. RESULTS: Of 656 lung transplant recipients, 101 (15.4%) had a PRA greater than 0, 37 (5.6%) had a PRA greater than 10%, and 20 (3.0%) had a PRA greater than 25%. Patients with a PRA greater than 25% had decreased median survival than did the rest of the patients (1.5 vs 5.2 years) and at 1 month (70% vs 90%), 1 year (65% vs 76%), and 5 years (31% vs 50%), respectively (p = 0.006, Wilcoxon's rank sum test) test). CONCLUSION: Significant elevation of PRA prior to lung transplantation is associated with worse survival, especially in the early post-transplant period. This may be due to a direct effect of anti-HLA antibodies on the allograft. The effectiveness of treatments such as plasmapheresis and intravenous immunoglobulin prior to transplantation needs to be evaluated.

Duke Scholars

Published In

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

ISSN

1053-2498

Publication Date

July 2005

Volume

24

Issue

7 Suppl

Start / End Page

S249 / S254

Location

united states

Related Subject Headings

  • Surgery
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

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MLA
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Hadjiliadis, D., Chaparro, C., Reinsmoen, N. L., Gutierrez, C., Singer, L. G., Steele, M. P., … Keshavjee, S. (2005). Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study. The Journal of Heart and Lung Transplantation : The Official Publication of the International Society for Heart Transplantation, 24(7 Suppl), S249–S254.
Hadjiliadis, D., C. Chaparro, N. L. Reinsmoen, C. Gutierrez, L. G. Singer, M. P. Steele, T. K. Waddell, et al. “Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study.The Journal of Heart and Lung Transplantation : The Official Publication of the International Society for Heart Transplantation 24, no. 7 Suppl (July 2005): S249–54.
Hadjiliadis D, Chaparro C, Reinsmoen NL, Gutierrez C, Singer LG, Steele MP, et al. Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2005 Jul;24(7 Suppl):S249–54.
Hadjiliadis, D., et al. “Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study.The Journal of Heart and Lung Transplantation : The Official Publication of the International Society for Heart Transplantation, vol. 24, no. 7 Suppl, July 2005, pp. S249–54.
Hadjiliadis D, Chaparro C, Reinsmoen NL, Gutierrez C, Singer LG, Steele MP, Waddell TK, Davis RD, Hutcheon MA, Palmer SM, Keshavjee S. Pre-transplant panel reactive antibody in lung transplant recipients is associated with significantly worse post-transplant survival in a multicenter study. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 2005 Jul;24(7 Suppl):S249–S254.
Journal cover image

Published In

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

ISSN

1053-2498

Publication Date

July 2005

Volume

24

Issue

7 Suppl

Start / End Page

S249 / S254

Location

united states

Related Subject Headings

  • Surgery
  • 1102 Cardiorespiratory Medicine and Haematology