Implications for Human Leukocyte Antigen Antibodies After Lung Transplantation

Snyder, Laurie D.; Wang, Ziwei; Chen, Dongfeng; Reinsmoen, Nancy L.; Finlen-Copeland, C. Ashley; Davis, William A.; Zaas, David; Palmer, Scott M.

doi:10.1378/chest.12-0587

Cited by 124 publications

(119 citation statements)

References 31 publications

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“…The ISHLT Pathology Council survey on C4d stains in the diagnosis of pulmonary ABMR (32) was reviewed ( Table 5). Discussion of the association of preformed and de novo DSA with various forms of antibody-mediated injury to the lung allograft suggested that early detection of DSA following lung transplantation and systematic monitoring with sensitive solid-phase platforms are recommended (33). The clinical overview of pulmonary ABMR was presented and overall conclusions revealed that to date survival is poor after ABMR, but improved with rapid clearance of the antibodies (34).…”

Section: Lung Allograftsmentioning

confidence: 99%

Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions

Haas

Sis

Racusen

et al. 2014

American Journal of Transplantation

1,226

1,159

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Section: Lung Allograftsmentioning

confidence: 99%

Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions

Haas

Sis

Racusen

et al. 2014

American Journal of Transplantation

1,226

1,159

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“…A recent study by Snyder et al 24 showed that de novo production of HLA antibodies was associated with development of BOS and poor survival, whereas DSA were only found to be predictive of poor survival. In our study we found DSA to be an independent predictor of development of BOS and poor survival.…”

Section: Discussionmentioning

confidence: 99%

De novo donor HLA-specific antibodies predict development of bronchiolitis obliterans syndrome after lung transplantation

Safavi

Robinson

Soresi

et al. 2014

The Journal of Heart and Lung Transplantation

110

102

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(2014) De novo donor HLA-specific antibodies predict development of bronchiolitis obliterans syndrome after lung transplantation. The Journal of Heart and Lung Transplantation, 33 (12). pp. 1273 -1281 . ISSN 1053 -2498 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/56766/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. There was a significant reduction in patient survival associated with de novo DSA (HR ¼ 1.886, p ¼ 0.047). In multivariable analyses, de novo DSA was an independent predictor for development of all stages of BOS as well as an independent predictor of poor patient survival. CONCLUSIONS: De novo DSA is a major risk factor for progression to BOS and shorter patient survival. Treatments to remove antibodies or limit antibody-mediated damage could be considered when DSA are first detected. However, a randomized, controlled trial of treatment options would enable a clearer understanding of the benefits, if any, of antibody-removal therapies.

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“…Primary graft dysfunction data were obtained through retrospective chart review. Grading of primary graft dysfunction was determined according to International Society of Heart and Lung Transplant guidelines (12) using the ratio of partial oxygen pressure to fraction of inspired oxygen assessed at 72 hours after transplant (13,14). Because chest X-rays could not be visually inspected for some patients, we did not differentiate between primary graft dysfunction grades 0 and 1.…”

Section: Medical Variablesmentioning

confidence: 99%

Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium

et al. 2016

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Rationale: Delirium is common following lung transplant and is associated with poorer clinical outcomes. The extent to which intraoperative hemodynamic alterations may contribute to postoperative delirium among lung transplant recipients has not been examined. Objectives:To examine the impact of intraoperative hemodynamic changes on neurobehavioral outcomes among lung transplant recipients.Methods: Intraoperative hemodynamic function during lung transplant was assessed in a consecutive series of patients between March and November 2013. Intraoperative cerebral perfusion pressure was assessed every minute in all patients. Following lung transplant, patients were monitored for the presence and severity of delirium using the Confusion Assessment Method and the Delirium Rating Scale until hospital discharge.Measurements and Main Results: Sixty-three patients received lung transplants, of whom 23 (37%) subsequently developed delirium. Lower cerebral perfusion pressure was associated with increased risk of delirium (odds ratio [OR], 2.08 per 10-mm Hg decrease; 95% confidence interval [CI], 1.02-4.24; P = 0.043), longer duration of delirium (OR, 1.7 d longer per 10-mm Hg decrease; 95% CI, 1.1-2.7; P = 0.022), and greater delirium severity (b = 20.81; 95% CI, 21.47 to 20.15; P = 0.017).Conclusions: Poorer cerebral perfusion pressure during lung transplant is associated with greater risk for delirium following transplant, as well as greater duration and severity of delirium, independent of demographic and medical predictors. Author Contributions: Concept and design, J.A.B., S.K.R., R.D.D., S.M.P., J.P.M., and P.J.S. Data collection, P.J.S., J.P.M., B.M.H., and S.K.R. Analysis and interpretation of the data, P.J.S., J.P.M., and J.A.B. Drafting of the manuscript, P.J.S., J.P.M., S.M.P., and J.A.B. Critical revision of the article for important intellectual content, P

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Implications for Human Leukocyte Antigen Antibodies After Lung Transplantation

Abstract: Approximately one-third of lung transplant recipients have detectable HLA antibodies, which are associated with a worse prognosis regarding graft function and patient survival.

Cited by 124 publications

References 31 publications

Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions

Banff 2013 Meeting Report: Inclusion of C4d-Negative Antibody-Mediated Rejection and Antibody-Associated Arterial Lesions

De novo donor HLA-specific antibodies predict development of bronchiolitis obliterans syndrome after lung transplantation

Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium

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