Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation.
| dc.contributor.author | Stoker, Alexander | |
| dc.contributor.author | Hicks, Anne | |
| dc.contributor.author | Wright, Mary Cooter | |
| dc.contributor.author | Ali, Azfar | |
| dc.contributor.author | Klapper, Jacob | |
| dc.contributor.author | Poisson, Jessica | |
| dc.contributor.author | Zaffiri, Lorenzo | |
| dc.contributor.author | Chen, Dongfeng | |
| dc.contributor.author | Hartwig, Matthew | |
| dc.contributor.author | Ghadimi, Kamrouz | |
| dc.contributor.author | Welsby, Ian | |
| dc.contributor.author | Bottiger, Brandi | |
| dc.date.accessioned | 2024-04-25T09:45:32Z | |
| dc.date.available | 2024-04-25T09:45:32Z | |
| dc.date.issued | 2023-09 | |
| dc.description.abstract | ObjectivesThe development of new human leukocyte antigens (HLAs) and donor-specific antibodies (DSAs) in patients are associated with worse outcomes following lung transplantation. The authors aimed to examine the relationship between blood product transfusion in the first 72 hours after lung transplantation and the development of HLA antibodies, including DSAs.DesignA retrospective observational study.SettingAt a single academic tertiary center.ParticipantsAdult lung transplant recipients who underwent transplantation between September 2014 and June 2019.InterventionsNone.Measurements and main resultsA total of 380 patients were included in this study, and 87 (23%) developed de novo donor-specific antibodies in the first year after transplantation. Eighty-five patients (22%) developed new HLA antibodies that were not donor-specific, and 208 patients (55%) did not develop new HLA antibodies in the first year after transplantation. Factors associated with increased HLA and DSA development included donor pulmonary infection, non-infectious indication for transplant, increased recipient body mass index, and a preoperative calculated panel reactive antibody value above 0. Multivariate analysis identified platelet transfusion associated with an increased risk of de novo HLA antibody development compared to the negative group (odds ratio [OR; 95% CI] 1.18 [1.02-1.36]; p = 0.025). Cryoprecipitate transfusion was associated with de novo DSA development compared to the negative group (OR [95% CI] 2.21 [1.32-3.69] for 1 v 0 units; p = 0.002).ConclusionsIncreased perioperative transfusion of platelets and cryoprecipitate are associated with de novo HLA and DSA development, respectively, in lung transplant recipients during the first year after transplantation. | |
| dc.identifier | S1053-0770(23)00274-4 | |
| dc.identifier.issn | 1053-0770 | |
| dc.identifier.issn | 1532-8422 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Elsevier BV | |
| dc.relation.ispartof | Journal of cardiothoracic and vascular anesthesia | |
| dc.relation.isversionof | 10.1053/j.jvca.2023.04.038 | |
| dc.rights.uri | ||
| dc.subject | Humans | |
| dc.subject | Isoantibodies | |
| dc.subject | HLA Antigens | |
| dc.subject | Lung Transplantation | |
| dc.subject | Retrospective Studies | |
| dc.subject | Graft Rejection | |
| dc.subject | Adult | |
| dc.subject | Tissue Donors | |
| dc.title | Development of New Donor-Specific and Human Leukocyte Antigen Antibodies After Transfusion in Adult Lung Transplantation. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Hartwig, Matthew|0000-0001-8393-2791 | |
| duke.contributor.orcid | Ghadimi, Kamrouz|0000-0002-9287-7541 | |
| duke.contributor.orcid | Welsby, Ian|0000-0002-2789-5612 | |
| duke.contributor.orcid | Bottiger, Brandi|0000-0002-0844-1412 | |
| pubs.begin-page | 1609 | |
| pubs.end-page | 1617 | |
| pubs.issue | 9 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Anesthesiology | |
| pubs.organisational-group | Anesthesiology, Cardiothoracic | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Pathology | |
| pubs.organisational-group | Surgery | |
| pubs.organisational-group | Medicine, Hematology | |
| pubs.organisational-group | Medicine, Pulmonary, Allergy, and Critical Care Medicine | |
| pubs.organisational-group | Surgery, Cardiovascular and Thoracic Surgery | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.publication-status | Published | |
| pubs.volume | 37 |
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