Antibody-mediated rejection and donor-specific antibodies
Evidence level: abstract-only observational studies; association, not causation
Donor-specific HLA antibodies and antibody-mediated rejection are reported to be associated with CLAD, particularly the restrictive form.
As of . Primary source: Tikkanen et al. 2016 (DOI).
Summary
According to the abstracts read, de novo DQ donor-specific antibodies were associated with about a twofold higher hazard of CLAD in a cohort of 340 recipients; persistent and transient donor-specific antibodies were associated with shorter CLAD-free survival in a cohort of 362 recipients, with the authors suggesting an overlap between antibody-mediated rejection and restrictive CLAD; and a KU Leuven case-control study reports persistent donor-specific antibodies and antibody-mediated rejection as strongly associated with later RAS. A Toronto study of 89 recipients also reports that de novo donor-specific antibody exposure conferred increased CLAD risk. All are observational and show association; this record gives no advice.
Sources and links
Related
Links from this record
- supports: De Novo DQ Donor-Specific Antibodies Are Associated with Chronic Lung Allograft Dysfunction after Lung Transplantation
- supports: Donor-specific and -nonspecific HLA antibodies and outcome post lung transplantation
- supports: Clinical predictors for restrictive allograft syndrome: A nested case-control study.
- supports: Humoral immunity to lung antigens early post-transplant confers risk for chronic lung allograft dysfunction.
- related to: Humoral (antibody-mediated) alloimmunity
- measured by: HLA donor-specific antibody and non-HLA antibody testing
- reported association: Restrictive allograft syndrome (RAS)
Linked from (derived)
- defines: International Society for Heart and Lung Transplantation Scientific Statement on pulmonary antibody-mediated rejection and proposed graft, antibody, and pathology (GAP) definition
- relates to: Donor and recipient human leukocyte antigen-G polymorphisms modulate the risk of adverse immunologic events following lung transplantation
- studies: Prognosis and Risks for Probable Chronic Lung Allograft Dysfunction: A Prospective Multicenter Study
- affects: Pulmonary antibody-mediated rejection has dismal outcomes and no established treatment platform
Known gaps in this record
- ISHLT antibody-mediated rejection statement not opened
- full text of all sources
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.