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Human leukocyte antigens antibodies after lung transplantation: Primary results of the HALT study
Author(s) -
Hachem Ramsey R.,
Kamoun Malek,
Budev Marie M.,
Askar Medhat,
Ahya Vivek N.,
Lee James C.,
Levine Deborah J.,
Pollack Marilyn S.,
Dhillon Gundeep S.,
Weill David,
Schechtman Kenneth B.,
Leard Lorriana E.,
Golden Jeffrey A.,
BaxterLowe LeeAnn,
Mohanakumar Thalachallour,
Tyan Dolly B.,
Yusen Roger D.
Publication year - 2018
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14893
Subject(s) - medicine , human leukocyte antigen , lung transplantation , transplantation , panel reactive antibody , donor specific antibodies , lung , antigen , prospective cohort study , antibody , incidence (geometry) , oncology , gastroenterology , immunology , physics , optics
Donor‐specific antibodies ( DSA ) to mismatched human leukocyte antigens ( HLA ) are associated with worse outcomes after lung transplantation. To determine the incidence and characteristics of DSA early after lung transplantation, we conducted a prospective multicenter observational study that used standardized treatment and testing protocols. Among 119 transplant recipients, 43 (36%) developed DSA : 6 (14%) developed DSA only to class I HLA , 23 (53%) developed DSA only to class II HLA , and 14 (33%) developed DSA to both class I and class II HLA . The median DSA mean fluorescence intensity ( MFI ) was 3197. We identified a significant association between the Lung Allocation Score and the development of DSA ( HR = 1.02, 95% CI : 1.001‐1.03, P = .047) and a significant association between DSA with an MFI ≥ 3000 and acute cellular rejection ( ACR ) grade ≥ A2 ( HR = 2.11, 95% CI : 1.04‐4.27, P = .039). However, we did not detect an association between DSA and survival. We conclude that DSA occur frequently early after lung transplantation, and most target class II HLA . DSA with an MFI ≥ 3000 have a significant association with ACR . Extended follow‐up is necessary to determine the impact of DSA on other important outcomes.