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HLA-specific antibodies are risk factors for lymphocytic bronchiolitis and chronic lung allograft dysfunction.
Girnita, Alin L; Duquesnoy, Rene; Yousem, Samuel A; Iacono, Aldo T; Corcoran, Timothy E; Buzoianu, Manuela; Johnson, Bruce; Spichty, Kathy J; Dauber, James H; Burckart, Gilbert; Griffith, Bartley P; McCurry, Kenneth R; Zeevi, Adriana.
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  • Girnita AL; Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Am J Transplant ; 5(1): 131-8, 2005 Jan.
Article en En | MEDLINE | ID: mdl-15636621
Bronchiolitis obliterans syndrome (BOS) represents a major limitation in lung transplantation. While acute rejection is widely considered the most important risk factor for BOS, the impact of HLA-specific antibodies is less understood. Of 51 lung recipients who were prospectively tested during a 4.2 +/- 1.6-year period, 14 patients developed HLA-specific antibodies. A multi-factorial analysis was performed to correlate the prevalence of BOS with HLA antibodies, persistent-recurrent acute rejection (ACR-PR), lymphocytic bronchiolitis, and HLA-A, -B, and -DR mismatches. HLA-specific antibodies were associated with ACR-PR (10/14 vs. 11/37 with no antibodies, p < 0.05), lymphocytic bronchiolitis (8/14 vs. 10/37, p < 0.05), and BOS (10/14, vs. 9/37, p < 0.005). Other risk factors for BOS were: lymphocytic bronchiolitis (13/18 vs. 6/33 with no lymphocytic bronchiolitis, p < 0.0001), ACR-PR (12/21 vs. 7/30 with no ACR-PR, p < 0.05), and the number of HLA-DR mismatches (1.7 +/- 0.48 in BOS vs. 1.2 +/- 0.63 without BOS, p < 0.05). The presence of antibodies exhibited a cumulative effect on BOS when it was associated with either lymphocytic bronchiolitis or ACR-PR. The complex relationship between the development of HLA antibodies and acute and chronic lung allograft rejection determines the importance of post-transplant screening for HLA-specific antibodies as a prognostic element for lung allograft outcome.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bronquiolitis / Bronquiolitis Obliterante / Trasplante de Pulmón / Antígenos HLA Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2005 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Buscar en Google
Añadir a Mi BVS
Imprimir
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PubMed Links

Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bronquiolitis / Bronquiolitis Obliterante / Trasplante de Pulmón / Antígenos HLA Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Transplant Asunto de la revista: TRANSPLANTE Año: 2005 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos