Dataset Information

Human leukocyte antigens antibodies after lung transplantation: Primary results of the HALT study.

ABSTRACT: Donor-specific antibodies (DSA) to mismatched human leukocyte antigens (HLA) are associated with worse outcomes after lung transplantation. To determine the incidence and characteristics of DSA early after lung transplantation, we conducted a prospective multicenter observational study that used standardized treatment and testing protocols. Among 119 transplant recipients, 43 (36%) developed DSA: 6 (14%) developed DSA only to class I HLA, 23 (53%) developed DSA only to class II HLA, and 14 (33%) developed DSA to both class I and class II HLA. The median DSA mean fluorescence intensity (MFI) was 3197. We identified a significant association between the Lung Allocation Score and the development of DSA (HR = 1.02, 95% CI: 1.001-1.03, P = .047) and a significant association between DSA with an MFI ? 3000 and acute cellular rejection (ACR) grade ? A2 (HR = 2.11, 95% CI: 1.04-4.27, P = .039). However, we did not detect an association between DSA and survival. We conclude that DSA occur frequently early after lung transplantation, and most target class II HLA. DSA with an MFI ? 3000 have a significant association with ACR. Extended follow-up is necessary to determine the impact of DSA on other important outcomes.

SUBMITTER: Hachem RR

PROVIDER: S-EPMC6117197 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Human leukocyte antigens antibodies after lung transplantation: Primary results of the HALT study.

Hachem Ramsey R RR Kamoun Malek M Budev Marie M MM Askar Medhat M Ahya Vivek N VN Lee James C JC Levine Deborah J DJ Pollack Marilyn S MS Dhillon Gundeep S GS Weill David D Schechtman Kenneth B KB Leard Lorriana E LE Golden Jeffrey A JA Baxter-Lowe LeeAnn L Mohanakumar Thalachallour T Tyan Dolly B DB Yusen Roger D RD

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 20180515 9

Donor-specific antibodies (DSA) to mismatched human leukocyte antigens (HLA) are associated with worse outcomes after lung transplantation. To determine the incidence and characteristics of DSA early after lung transplantation, we conducted a prospective multicenter observational study that used standardized treatment and testing protocols. Among 119 transplant recipients, 43 (36%) developed DSA: 6 (14%) developed DSA only to class I HLA, 23 (53%) developed DSA only to class II HLA, and 14 (33%) ...[more]

PMID: 29687961

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Project description:BackgroundCorneal transplantation is the most frequently performed transplantation in the UK. Despite this, the therapeutic value of matching human leukocyte antigen (HLA) subtypes for transplanted corneas remains controversial. Ocular immune privilege was originally deemed to render matching unnecessary; however, more recently, matching has demonstrated improved outcomes including graft success, amongst others. This systematic review aims to evaluate the effectiveness of major and minor antigen matching on graft outcomes in corneal transplantation.MethodsStandard systematic review methodology will be used to identify, select and extract data from observational studies and clinical trials assessing the effects of HLA matching on corneal graft outcomes. Bibliographic databases (Cochrane Library, EMBASE, MEDLINE, Web of Science, Scopus), clinical trial registers, abstract and conference proceedings, in addition to dissertation, thesis and grey literature will be searched. Neither date of publication nor language will be restricted, and non-English articles will be translated where necessary. The primary outcome will be to assess corneal graft success for different degrees of HLA matching/mismatching. The precise end outcome measure varies amongst studies and includes graft rejection, immunoreaction, failure and survival. Therefore, data will be extracted across all relevant outcome parameters and grouped for subsequent statistical tests. Risk of bias assessment will be completed, appropriate to each study design. Study selection, data extraction and risk of bias assessment will be independently completed by two reviewers. Data will be tabulated, and a narrative synthesis presented. Meta-analysis will be performed where there is sufficient homogeneity between studies to warrant its effective completion. Subgroup and sensitivity analysis will be undertaken if appropriate.DiscussionMany studies have investigated the effectiveness of HLA matching for corneal transplantation. A systematic review is needed to collate and analyse this evidence. Findings of this systematic review may form the basis of evidence-based recommendations on pre-operative HLA typing and matching of corneal grafts for transplantation.Systematic review registrationPROSPERO reference CRD42020198882.

Dataset Information

Human leukocyte antigens antibodies after lung transplantation: Primary results of the HALT study.

Publications

Human leukocyte antigens antibodies after lung transplantation: Primary results of the HALT study.

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