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首页> 外文期刊>BMC Pulmonary Medicine >Prevalence of pre-transplant anti-HLA antibodies and their impact on outcomes in lung transplant recipients
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Prevalence of pre-transplant anti-HLA antibodies and their impact on outcomes in lung transplant recipients

机译：预移植前抗HLA抗体的患病率及其对肺移植受者结果的影响

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Previous studies have suggested that antibodies against human leukocyte antigen (HLA) are associated with worse outcomes in lung transplantation. However, little is known about the factors associated with outcomes following lung transplantation in Asia. Accordingly, we investigated the prevalence of anti-HLA antibodies in recipients before transplantation and assessed their impact on outcomes in Korea. A single-center retrospective study was conducted. The study included 76 patients who received a lung transplant at a tertiary hospital in South Korea between January 2010 and March 2015. Nine patients (11.8%) had class I and/or class II panel-reactive antibodies greater than 50%. Twelve patients (15.8%) had anti-HLA antibodies with a low mean fluorescence intensity (MFI, 1000–3000), 7 (9.2%) with a moderate MFI (3000–5000), and 12 (15.8%) with a high MFI (>?5000). Ten patients (13.2%) had suspected donor-specific antibodies (DSA), and 60% (6/10) of these patients had antibodies with a high MFI. In an analysis of outcomes, high-grade (≥2) primary graft dysfunction (PGD) was more frequent in patients with anti-HLA antibodies with moderate-to-high MFI values than in patients with low MFI values (39.4% vs. 14.0%, p?=?0.011). Of 20 patients who survived longer than 2?years and evaluated for pBOS after transplant, potential bronchiolitis obliterans syndrome (pBOS) or BOS was more frequent in patients with anti-HLA antibodies with moderate-to-high MFI than in patients with low MFI, although this difference was not statistically significant (50.0% vs. 14.3%, p?=?0.131). The prevalence of anti-HLA antibodies with high MFI was not high in Korea. However, the MFI was relatively high in patients with DSA. Anti-HLA antibodies with moderate-to-high MFI values were related to high-grade PGD. Therefore, recipients with high MFI before lung transplantation should be considered for desensitization and close monitoring.
机译：以前的研究表明，针对人白细胞抗原（HLA）的抗体与肺移植中的更糟糕的结果有关。然而，对于亚洲肺移植后的结果几乎是众所周知的。因此，我们研究了移植前接受者抗HLA抗体的患病率，并评估了对韩国的结果的影响。进行单中心回顾性研究。该研究包括76名患者在2010年1月至2015年3月期间在韩国的第三级医院接受了肺部移植患者。九名患者（11.8％）的Ⅰ类和/或II类 - 反应性抗体大于50％。 12名患者（15.8％）具有抗HLA抗体，具有低平均荧光强度（MFI，1000-3000），7（9.2％），中等MFI（3000-5000），12（15.8％），具有高MFI （>？5000）。 10名患者（13.2％）已怀疑供体特异性抗体（DSA），60％（6/10）这些患者患有高MFI的抗体。在分析结果中，高级（≥2）初级移植物功能障碍（PGD）在具有中等至高MFI值的抗HLA抗体患者中更频繁地频繁，而不是低MFI值的患者（39.4％对14.0 ％，p？=？0.011）。 20例患者存活超过2岁的患者，在移植后对PBO评估，潜在的支气管炎抑制症综合征（PBO）或BOS在抗HLA抗体患者中更频繁地频繁，中度至高MFI患者比低MFI患者，虽然这种差异没有统计学意义（50.0％与14.3％，p？= 0.131）。韩国高MFI抗HLA抗体的患病率在韩国不高。然而，在DSA患者患者中，MFI相对较高。具有中等至高MFI值的抗HLA抗体与高级PGD有关。因此，应考虑在肺移植前的高MFI接受者进行脱敏和密切监测。

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