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The impact of pre-transplant allosensitization on outcomes after lung transplantation
Open accessAbstract
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 recipients between 1/1/2006 and 12/31/2012. 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 (CPRA), 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 We conclude that pre-transplant allosensitization does not adversely affect outcomes after lung transplantation when the potentially reactive HLA are avoided in the donor by a virtual crossmatch with the recipient.
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Some centers describe successful lung transplantation despite positive cross match.
“some centers describe successful lung transplantation despite positive cross match.(62, 63)”
From Consensus document for the selection of lung transplant candidates: An update from the International Society for Heart and Lung Transplantation. (2021) · cites this paper as [62]
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References 23 · Cited by 45
Metadata
- Authors
- Bosanquet, J. P., Witt, C. A., Bemiss, B. C., Byers, D. E., Yusen, R. D., Patterson, A. G., Kreisel, D., Mohanakumar, T., Trulock, E. P., & Hachem, R. R.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Hachem, Ramsey R.
- ORCID
- Venue
- The Journal of Heart and Lung Transplantation
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 34
- Issue
- 11
- Pages
- 1415-1422
- ISSN
- 1053-2498 (ISSN-L)
- PMC
- PMC4619119
- OpenAlex
- W2117909590
- Semantic Scholar
- fc277ff50cbb0e67ad04e182a7250c4506ddd182
- Cited by
- 45
- References
- 23
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 6 · 2016: 4
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Heart and Lung Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R34HL105412, HL056643, R01HL056643, HL 105412, T32HL007317)
- Topics
- Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Keywords
- lung transplantation, HLA antibodies, virtual crossmatch, panel reactive antibody, donor-specific HLA antibodies, acute cellular rejection, lymphocytic bronchiolitis, chronic lung allograft dysfunction, graft failure, transplant outcomes
- MeSH terms
- Female, Follow-Up Studies, Graft Rejection, Histocompatibility Testing, HLA Antigens, Humans, Immunization, Isoantibodies, Male, Middle Aged, Missouri, Preoperative Care, Retrospective Studies, Time Factors, Tissue Donors, Incidence, Proportional Hazards Models, Lung Transplantation, Transplant Recipients
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