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Comparative analysis of how immune sensitization is defined prior to lung transplantation.
Hum Immunol. 2015 Oct; 76(10):711-6.HI

Abstract

BACKGROUND

Immune sensitization prior to lung transplantation may be associated with worse survival. Using solid phase assays to define sensitization, we assessed the relationship between PRA status, donor specific anti-HLA antibodies (DSA) pre-transplant, cytotoxic cross match results and the clinical outcomes following lung transplantation.

METHODS

Luminex assays determined the presence of antibodies to class I and class II MHC molecules prior to lung transplantation. At the time of transplant, the PRA status, the presence of DSA and prospective cytotoxic cross match result were analysed in 195 patients undergoing lung transplantation between June 2008 and June 2012. Clinical outcomes analysed included acute cellular and antibody-mediated rejection, chronic lung allograft dysfunction (CLAD) and mortality.

RESULTS

At the time of transplant, 45% of patients had a positive PRA and 29% had DSA. On univariate analysis, the presence of pre-transplant class I or II anti-HLA donor-specific antibodies was not associated with the development of chronic lung allograft dysfunction (CLAD) despite significant associations with PRA status and B-cell crossmatch.

CONCLUSION

Defining sensitization using solid phase assays provide additional details regarding donor-specific sensitization but did not provide additional prognostic information to that provided by historically available cell-based cross-match assays.

Authors+Show Affiliations

Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia.Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia.Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Vic 3181, Australia; Clinical Haematology Department, The Alfred Hospital, Melbourne, Vic 3181, Australia.National Transplant Services, Australian Red Cross Blood Services, Melbourne, Australia.Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia.Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia.Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia.Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Vic 3181, Australia. Electronic address: G.Westall@alfred.org.au.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26429328

Citation

Chin, N, et al. "Comparative Analysis of How Immune Sensitization Is Defined Prior to Lung Transplantation." Human Immunology, vol. 76, no. 10, 2015, pp. 711-6.
Chin N, Paraskeva M, Paul E, et al. Comparative analysis of how immune sensitization is defined prior to lung transplantation. Hum Immunol. 2015;76(10):711-6.
Chin, N., Paraskeva, M., Paul, E., Cantwell, L., Levvey, B., Williams, T., Snell, G., & Westall, G. (2015). Comparative analysis of how immune sensitization is defined prior to lung transplantation. Human Immunology, 76(10), 711-6. https://doi.org/10.1016/j.humimm.2015.09.025
Chin N, et al. Comparative Analysis of How Immune Sensitization Is Defined Prior to Lung Transplantation. Hum Immunol. 2015;76(10):711-6. PubMed PMID: 26429328.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative analysis of how immune sensitization is defined prior to lung transplantation. AU - Chin,N, AU - Paraskeva,M, AU - Paul,E, AU - Cantwell,L, AU - Levvey,B, AU - Williams,T, AU - Snell,G, AU - Westall,G, Y1 - 2015/09/30/ PY - 2014/07/17/received PY - 2015/08/23/revised PY - 2015/09/26/accepted PY - 2015/10/3/entrez PY - 2015/10/3/pubmed PY - 2016/8/10/medline KW - DSA KW - HLA sensitization KW - Lung transplantation KW - Outcomes KW - PRA SP - 711 EP - 6 JF - Human immunology JO - Hum. Immunol. VL - 76 IS - 10 N2 - BACKGROUND: Immune sensitization prior to lung transplantation may be associated with worse survival. Using solid phase assays to define sensitization, we assessed the relationship between PRA status, donor specific anti-HLA antibodies (DSA) pre-transplant, cytotoxic cross match results and the clinical outcomes following lung transplantation. METHODS: Luminex assays determined the presence of antibodies to class I and class II MHC molecules prior to lung transplantation. At the time of transplant, the PRA status, the presence of DSA and prospective cytotoxic cross match result were analysed in 195 patients undergoing lung transplantation between June 2008 and June 2012. Clinical outcomes analysed included acute cellular and antibody-mediated rejection, chronic lung allograft dysfunction (CLAD) and mortality. RESULTS: At the time of transplant, 45% of patients had a positive PRA and 29% had DSA. On univariate analysis, the presence of pre-transplant class I or II anti-HLA donor-specific antibodies was not associated with the development of chronic lung allograft dysfunction (CLAD) despite significant associations with PRA status and B-cell crossmatch. CONCLUSION: Defining sensitization using solid phase assays provide additional details regarding donor-specific sensitization but did not provide additional prognostic information to that provided by historically available cell-based cross-match assays. SN - 1879-1166 UR - https://www.unboundmedicine.com/medline/citation/26429328/Comparative_analysis_of_how_immune_sensitization_is_defined_prior_to_lung_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0198-8859(15)00462-0 DB - PRIME DP - Unbound Medicine ER -