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Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation.

Publication ,  Journal Article
Stoker, A; Hicks, A; Wright, MC; Ali, A; Klapper, J; Poisson, J; Zaffiri, L; Chen, D; Hartwig, M; Ghadimi, K; Welsby, I; Bottiger, B
Published in: J Cardiothorac Vasc Anesth
September 2023

OBJECTIVES: The development of new human leukocyte antigens (HLAs) and donor-specific antibodies (DSAs) in patients are associated with worse outcomes following lung transplantation. The authors aimed to examine the relationship between blood product transfusion in the first 72 hours after lung transplantation and the development of HLA antibodies, including DSAs. DESIGN: A retrospective observational study. SETTING: At a single academic tertiary center. PARTICIPANTS: Adult lung transplant recipients who underwent transplantation between September 2014 and June 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 380 patients were included in this study, and 87 (23%) developed de novo donor-specific antibodies in the first year after transplantation. Eighty-five patients (22%) developed new HLA antibodies that were not donor-specific, and 208 patients (55%) did not develop new HLA antibodies in the first year after transplantation. Factors associated with increased HLA and DSA development included donor pulmonary infection, non-infectious indication for transplant, increased recipient body mass index, and a preoperative calculated panel reactive antibody value above 0. Multivariate analysis identified platelet transfusion associated with an increased risk of de novo HLA antibody development compared to the negative group (odds ratio [OR; 95% CI] 1.18 [1.02-1.36]; p = 0.025). Cryoprecipitate transfusion was associated with de novo DSA development compared to the negative group (OR [95% CI] 2.21 [1.32-3.69] for 1 v 0 units; p = 0.002). CONCLUSIONS: Increased perioperative transfusion of platelets and cryoprecipitate are associated with de novo HLA and DSA development, respectively, in lung transplant recipients during the first year after transplantation.

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Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

September 2023

Volume

37

Issue

9

Start / End Page

1609 / 1617

Location

United States

Related Subject Headings

  • Tissue Donors
  • Retrospective Studies
  • Lung Transplantation
  • Isoantibodies
  • Humans
  • HLA Antigens
  • Graft Rejection
  • Anesthesiology
  • Adult
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Stoker, A., Hicks, A., Wright, M. C., Ali, A., Klapper, J., Poisson, J., … Bottiger, B. (2023). Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation. J Cardiothorac Vasc Anesth, 37(9), 1609–1617. https://doi.org/10.1053/j.jvca.2023.04.038
Stoker, Alexander, Anne Hicks, Mary Cooter Wright, Azfar Ali, Jacob Klapper, Jessica Poisson, Lorenzo Zaffiri, et al. “Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation.J Cardiothorac Vasc Anesth 37, no. 9 (September 2023): 1609–17. https://doi.org/10.1053/j.jvca.2023.04.038.
Stoker A, Hicks A, Wright MC, Ali A, Klapper J, Poisson J, et al. Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation. J Cardiothorac Vasc Anesth. 2023 Sep;37(9):1609–17.
Stoker, Alexander, et al. “Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation.J Cardiothorac Vasc Anesth, vol. 37, no. 9, Sept. 2023, pp. 1609–17. Pubmed, doi:10.1053/j.jvca.2023.04.038.
Stoker A, Hicks A, Wright MC, Ali A, Klapper J, Poisson J, Zaffiri L, Chen D, Hartwig M, Ghadimi K, Welsby I, Bottiger B. Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation. J Cardiothorac Vasc Anesth. 2023 Sep;37(9):1609–1617.
Journal cover image

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

September 2023

Volume

37

Issue

9

Start / End Page

1609 / 1617

Location

United States

Related Subject Headings

  • Tissue Donors
  • Retrospective Studies
  • Lung Transplantation
  • Isoantibodies
  • Humans
  • HLA Antigens
  • Graft Rejection
  • Anesthesiology
  • Adult
  • 3201 Cardiovascular medicine and haematology