Abstract
Background Allosensitization can be a significant barrier to transplantation for some patients, and previous studies suggested that pre-transplant allosensitization was associated with worse outcomes after lung transplantation. However, human leukocyte antigen (HLA) antibody testing has evolved significantly over the past 10 years, and current assays are highly sensitive and specific. Methods We examined the impact of pre-transplant allosensitization on post-transplant outcomes in the era of solid-phase multiplex HLA antibody detection assays in this retrospective, single-center study of 304 adult transplant recipients between January 1, 2006, and December 31, 2012. We accepted donor organs for allosensitized patients if a virtual crossmatch was compatible with all previously identified antibodies. Results In univariate and multivariate Cox proportional hazards models, pre-transplant allosensitization, the calculated panel reactive antibody, and the number of pre-transplant HLA antibodies were not associated with the development of acute cellular rejection, lymphocytic bronchiolitis, donor-specific HLA antibodies, chronic lung allograft dysfunction, or graft failure. Conclusions Pre-transplant allosensitization does not adversely affect outcomes after lung transplantation when the potentially reactive HLAs are avoided in the donor by a virtual crossmatch with the recipient.
Original language | English (US) |
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Pages (from-to) | 1415-1422 |
Number of pages | 8 |
Journal | Journal of Heart and Lung Transplantation |
Volume | 34 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2015 |
Funding
This work was supported in part the National Institutes of Health (Grant No. HL056643 to T.M. and R.R.H. and Grant No. HL105412 to R.D.Y., T.M., and R.R.H.).
Keywords
- allosensitization
- lung transplantation
- panel reactive antibody
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Transplantation
- Pulmonary and Respiratory Medicine
- Surgery