Evaluation of current strategies for surveillance and management of donor-specific antibodies: Single-center study

Clinical Transplantation
Daniel SullivanVaidehi Kaza

Abstract

Although the presence of donor-specific antibodies (DSA) is known to impact lung allograft, limited data exist regarding DSA management. We did a retrospective study at our center evaluating DSA management in adult lung transplant recipients undergoing lung transplantation between January 1, 2010 and June 30, 2014. Study follow-up was completed through October 2017. All recipients were stratified into 2 groups based on the presence or absence of DSA. Those with DSA were evaluated for the impact of treatment of DSA. The primary outcomes were postlung transplant survival and freedom from bronchiolitis obliterans syndrome (BOS), subset of chronic lung allograft dysfunction (CLAD). Simon-Makuch method was used to estimate overall survival and BOS-free survival to account for DSA as time-dependent covariate. Survival differences between the groups were analyzed using time-dependent Cox proportional hazards model. Sixty-four percent of 194 total subjects developed post-lung transplant DSA. Overall survival was different with worse survival in the DSA positive group that never cleared DSA (P = .002). BOS-free survival was lower, but did not reach significance in this group. Response to treatment was poor, with only 12 of 47 (25.5%) wh...Continue Reading

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Citations

Oct 4, 2020·BMC Pulmonary Medicine·Sakiko KumataYoshinori Okada
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