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Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients.

Publication ,  Journal Article
Snyder, LD; Wang, Z; Chen, D-F; Reinsmoen, NL; Finlen-Copeland, CA; Davis, WA; Zaas, DW; Palmer, SM
Published in: Chest
July 2013

BACKGROUND: Long-term survival after lung transplant is limited by the development of chronic and progressive airflow obstruction, a condition known as bronchiolitis obliterans syndrome (BOS). While prior studies strongly implicate cellular rejection as a strong risk factor for BOS, less is known about the clinical significance of human leukocyte antigen (HLA) antibodies and donor HLA-specific antibodies in long-term outcomes. METHODS: A single-center cohort of 441 lung transplant recipients, spanning a 10-year period, was prospectively screened for HLA antibodies after transplant using flow cytometry-based methods. The prevalence of and predictors for HLA antibodies were determined. The impact of HLA antibodies on survival after transplant and the development of BOS were determined using Cox models. RESULTS: Of the 441 recipients, 139 (32%) had detectable antibodies to HLA. Of these 139, 54 (39%) developed antibodies specific to donor HLA. The detection of posttransplant HLA antibodies was associated with BOS (HR, 1.54; P=.04) and death (HR, 1.53; P=.02) in multivariable models. The detection of donor-specific HLA antibodies was associated with death (HR, 2.42; P<.0001). The detection of posttransplant HLA antibodies was associated with pretransplant HLA-antibody detection, platelet transfusions, and the development of BOS and cytomegalovirus pneumonitis. CONCLUSIONS: Approximately one-third of lung transplant recipients have detectable HLA antibodies, which are associated with a worse prognosis regarding graft function and patient survival.

Duke Scholars

Published In

Chest

DOI

EISSN

1931-3543

Publication Date

July 2013

Volume

144

Issue

1

Start / End Page

226 / 233

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Prognosis
  • Prevalence
  • Middle Aged
  • Male
  • Lung Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Snyder, L. D., Wang, Z., Chen, D.-F., Reinsmoen, N. L., Finlen-Copeland, C. A., Davis, W. A., … Palmer, S. M. (2013). Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients. Chest, 144(1), 226–233. https://doi.org/10.1378/chest.12-0587
Snyder, Laurie D., Ziwei Wang, Dong-Feng Chen, Nancy L. Reinsmoen, C Ashley Finlen-Copeland, W Austin Davis, David W. Zaas, and Scott M. Palmer. “Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients.Chest 144, no. 1 (July 2013): 226–33. https://doi.org/10.1378/chest.12-0587.
Snyder LD, Wang Z, Chen D-F, Reinsmoen NL, Finlen-Copeland CA, Davis WA, et al. Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients. Chest. 2013 Jul;144(1):226–33.
Snyder, Laurie D., et al. “Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients.Chest, vol. 144, no. 1, July 2013, pp. 226–33. Pubmed, doi:10.1378/chest.12-0587.
Snyder LD, Wang Z, Chen D-F, Reinsmoen NL, Finlen-Copeland CA, Davis WA, Zaas DW, Palmer SM. Implications for human leukocyte antigen antibodies after lung transplantation: a 10-year experience in 441 patients. Chest. 2013 Jul;144(1):226–233.

Published In

Chest

DOI

EISSN

1931-3543

Publication Date

July 2013

Volume

144

Issue

1

Start / End Page

226 / 233

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Proportional Hazards Models
  • Prognosis
  • Prevalence
  • Middle Aged
  • Male
  • Lung Transplantation