Timing of basiliximab induction and development of acute rejection in lung transplant patients

Swarup, Rajeev; Allenspach, Lisa; Nemeh, Hassan; Stagner, Lisa; Betensley, Alan D.

doi:10.1016/j.healun.2011.05.009

Cited by 25 publications

(12 citation statements)

References 29 publications

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“…PGD, primary graft dysfunction (PGD 3 vs. PGD 0‐2) ; AR score, acute rejection score, defined by the number of biopsy‐proven cellular AR episodes during the first 12 months after lung transplantation (LTx) ; Anti‐HLA Abs, anti‐HLA antibodies detected against HLA Class I and Class II antigen and identified by single‐antigen flow‐beads Luminex assay at visit 1 at 3 months (V1) or at visit 2 at 12 months (V2) (yes/no); Lymphocytic bronchiolitis (yes/no); Procedure: surgical procedure (single LTx vs. bilateral LTx); Graft HLA‐G expression: lung HLA‐G+ (positive) versus lung HLA‐G− (negative) patients; Lung HLA‐G + (positive) patients if transbronchial biopsies at V1 or at V2 were considered HLA‐G positive, with bronchial epithelium stained with MEM‐G/2 mAb. The remaining patients were considered lung HLA‐G negative.…”

Section: Resultsmentioning

confidence: 99%

“…TBBx specimens were not analyzed in cases of viral infection with cytomegalovirus (CMV), herpes or influenza A viruses detected in BALF because these viruses are specifically known to up‐regulate HLA‐G expression in bronchial epithelium . An AR score was defined by the number of biopsy‐proven cellular AR episodes during the first 12 months after LTx . Patients with CLAD were classified by two clinical phenotypes: bronchiolitis obliterans syndrome (BOS) defined by the classical definition of the ISHLT or restrictive allograft syndrome (RAS) .…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Role of HLA-G as a Predictive Marker of Low Risk of Chronic Rejection in Lung Transplant Recipients: A Clinical Prospective Study

Brugière

Thabut

Krawice-Radanne

et al. 2015

American Journal of Transplantation

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Human leukocyte antigen G (HLA‐G) expression is thought to be associated with a tolerance state following solid organ transplantation. In a lung transplant (LTx) recipient cohort, we assessed (1) the role of HLA‐G expression as a predictor of graft acceptance, and (2) the relationship between (i) graft and peripheral HLA‐G expression, (ii) HLA‐G expression and humoral immunity and (iii) HLA‐G expression and lung microenvironment. We prospectively enrolled 63 LTx recipients (median follow‐up 3.26 years [min: 0.44–max: 5.03]). At 3 and 12 months post‐LTx, we analyzed graft HLA‐G expression by immunohistochemistry, plasma soluble HLA‐G (sHLA‐G) level by enzyme–linked immunosorbent assay, bronchoalveolar lavage fluid (BALF) levels of cytokines involved in chronic lung allograft dysfunction (CLAD) and anti‐HLA antibodies (Abs) in serum. In a time‐dependent Cox model, lung HLA‐G expression had a protective effect on CLAD occurrence (hazard ratio: 0.13 [0.03–0.58]; p = 0.008). The same results were found when computing 3‐month and 1‐year conditional freedom from CLAD (p = 0.03 and 0.04, respectively [log‐rank test]). Presence of anti‐HLA Abs was inversely associated with graft HLA‐G expression (p = 0.02). Increased BALF level of transforming growth factor‐β was associated with high plasma sHLA‐G level (p = 0.02). In conclusion, early graft HLA‐G expression in LTx recipients with a stable condition was associated with graft acceptance in the long term.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Role of HLA-G as a Predictive Marker of Low Risk of Chronic Rejection in Lung Transplant Recipients: A Clinical Prospective Study

Brugière

Thabut

Krawice-Radanne

et al. 2015

American Journal of Transplantation

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“…Cumulative acute rejection score (CAR) score is not used universally but many authors have found that it is a useful tool for measuring and assessing combined severity and frequency of rejection over time. CAR score and CAR score divided by the number of evaluable TBBs has been used elsewhere and reported in other studies [11,13,20,25]. …”

Section: Discussionmentioning

confidence: 99%

Lower incidence of CMV infection and acute rejections with valganciclovir prophylaxis in lung transplant recipients

et al. 2013

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BackgroundCytomegalovirus (CMV) is the most common opportunistic infection following lung transplantation. CMV replication in the lung allograft is described as accelerating the development of bronchiolitis obliterans syndrome (BOS). Finding a strategy to prevent CMV infection is an important issue.MethodsWe performed a retrospective, single-centre study of 114 lung transplant recipients (LTRs) who underwent lung transplantation from January 2001 to December 2006. In a smaller cohort of 88 CMV seropositive (R+) LTRs, three months of valganciclovir prophylaxis (2004-2006) was compared to three months of oral ganciclovir (2001-2003) with respect to the incidence of CMV infection/disease, the severity of CMV disease, acute rejection, BOS-free 4 year survival and 4 year survival. In the whole group of 114 LTRs the impact of CMV infection on long-term survival (BOS free 4 year survival and 6 year survival) was assessed.ResultsFor the cohort of 88 CMV seropositive LTRs, the incidence of CMV infection/disease at one year was lower in the valganciclovir group compared to the ganciclovir group (24% vs. 54%, p = 0.003). There was a tendency towards reduced CMV disease, from 33% to 20% and a significant lower incidence of asymptomatic CMV infection (22% vs. 4%, p = 0.005). A lower incidence of acute rejection was observed in the valganciclovir group. However, there was no significant difference between the two groups in BOS free 4 year survival and 4 year survival.For the entire group of 114 LTRs, BOS-free 4 year survival for recipients with CMV disease was (32%, p = 0.005) and among those with asymptomatic CMV infection (36%, p = 0.061) as compared with patients without CMV infection (69%). Six year survival was lower among patients with CMV disease, (64%, p = 0.042) and asymptomatic CMV infection (55%, p = 0.018) than patients without CMV infection (84%).ConclusionsA lower incidence of CMV infection/disease and acute rejections was observed with valganciclovir (3 months) when compared to oral ganciclovir (3 months). The long-term impact of CMV infection/disease was significant for BOS-free survival and survival.

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“…A cumulative acute rejection (CAR) score in the first year post-transplant was calculated for each patient. 24 Development of chronic rejection, bronchiolitis obliterans syndrome (BOS), was determined in accordance with ISHLT criteria. 25,26 The standard maintenance immunosuppression regimen during the study period included a calcineurin inhibitor (tacrolimus), an anti-metabolite (azathioprine) and steroids.…”

Section: Clinical Datamentioning

confidence: 99%

Low vitamin D levels are associated with increased rejection and infections after lung transplantation

Lowery

Bemiss

Cascino

et al. 2012

The Journal of Heart and Lung Transplantation

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Timing of basiliximab induction and development of acute rejection in lung transplant patients

Cited by 25 publications

References 29 publications

Role of HLA-G as a Predictive Marker of Low Risk of Chronic Rejection in Lung Transplant Recipients: A Clinical Prospective Study

Role of HLA-G as a Predictive Marker of Low Risk of Chronic Rejection in Lung Transplant Recipients: A Clinical Prospective Study

Lower incidence of CMV infection and acute rejections with valganciclovir prophylaxis in lung transplant recipients

Low vitamin D levels are associated with increased rejection and infections after lung transplantation

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