دورية أكاديمية
Comparison of de novo donor-specific antibodies between living and cadaveric lung transplantation.
العنوان: | Comparison of de novo donor-specific antibodies between living and cadaveric lung transplantation. |
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المؤلفون: | Gochi F; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Chen-Yoshikawa TF; Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan., Kayawake H; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Ohsumi A; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Tanaka S; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Yamada Y; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Yutaka Y; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Nakajima D; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Hamaji M; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan., Yurugi K; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan., Hishida R; Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan., Date H; Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: hdate@kuhp.kyoto-u.ac.jp. |
المصدر: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2021 Jul; Vol. 40 (7), pp. 607-613. Date of Electronic Publication: 2021 Mar 29. |
نوع المنشور: | Comparative Study; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 9102703 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-3117 (Electronic) Linking ISSN: 10532498 NLM ISO Abbreviation: J Heart Lung Transplant Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1999- : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby-Year Book, Inc., c1991- |
مواضيع طبية MeSH: | Living Donors* , Lung Transplantation*, Antibodies/*immunology , Graft Rejection/*immunology , HLA Antigens/*immunology, Adult ; Cadaver ; Female ; Follow-Up Studies ; Graft Rejection/epidemiology ; Humans ; Incidence ; Japan/epidemiology ; Kaplan-Meier Estimate ; Male ; Retrospective Studies ; Survival Rate/trends |
مستخلص: | Background: Despite growing interest in donor-specific antibodies (DSAs) and antibody-mediated rejection (AMR) in lung transplantation (LTx), no study evaluating the outcomes in recipients with de novo DSAs (dnDSAs) in living-donor lobar LTx (LDLLT) exists. We compared various characteristics of DSAs in LDLLT with those in cadaveric LTx (CLT) based on prospectively collected data. Methods: Between October 2009 and September 2019, 211 recipients underwent LTx (128 CLTs and 83 LDLLTs). We reviewed 108 CLTs and 74 LDLLTs to determine the characteristics and clinical impact of dnDSAs. Eighteen data-deficient cases, 7 cases with preformed DSAs, and 4 re-transplants were excluded. Results: There were significant differences between CLT and LDLLT patients in age, primary disease, ischemic time, and number of human leukocyte antigen mismatches per donor. The dnDSA incidence in LDLLT (6.8%) was significantly lower than that in CLT (19.4%, p = 0.02). The dnDSAs appeared later in LDLLT (mean 1,256 days) than in CLT (mean 196 days, p = 0.003). According to Cox models analyzed using dnDSA as a time-dependent covariate, dnDSA positivity was significantly associated with a poor overall survival (OS; hazard ratio [HR] 3.46, 95% confidence interval [CI] 1.59-7.57, p = 0.002) and poor CLAD-free survival in case of CLT (HR: 2.23, 95% CI: 1.08-4.63, p = 0.003). However, no such significant associations were noted in case of LDLLT. Conclusions: The dnDSA occurrence was significantly lower and later in LDLLT than in CLT. Furthermore, dnDSA-positivity was significantly associated with worse OS and CLAD-free survival after CLT but not after LDLLT. Competing Interests: Conflicts of interest The authors have no conflicts of interest or funding to disclose. (Copyright © 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.) |
فهرسة مساهمة: | Keywords: anti-HLA antibody; donor specific antibody; living-donor lobar lung transplantation; lung transplantation |
المشرفين على المادة: | 0 (Antibodies) 0 (HLA Antigens) |
تواريخ الأحداث: | Date Created: 20210603 Date Completed: 20220131 Latest Revision: 20220131 |
رمز التحديث: | 20231215 |
DOI: | 10.1016/j.healun.2021.03.019 |
PMID: | 34078558 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1557-3117 |
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DOI: | 10.1016/j.healun.2021.03.019 |