Frontiers in Medicine (Oct 2017)

Characteristics of Donor-Specific Antibodies Associated With Antibody-Mediated Rejection in Lung Transplantation

  • Antoine Roux,
  • Antoine Roux,
  • Antoine Roux,
  • Ines Bendib Le Lan,
  • Sonia Holifanjaniaina,
  • Kimberly A. Thomas,
  • Clément Picard,
  • Dominique Grenet,
  • Sandra De Miranda,
  • Benoit Douvry,
  • Laurence Beaumont-Azuar,
  • Edouard Sage,
  • Edouard Sage,
  • Jérôme Devaquet,
  • Elise Cuquemelle,
  • Morgan Le Guen,
  • Caroline Suberbielle,
  • Chantal Gautreau,
  • Marc Stern,
  • Maura Rossetti,
  • Abdul Monem Hamid,
  • Francois Parquin

DOI
https://doi.org/10.3389/fmed.2017.00155
Journal volume & issue
Vol. 4

Abstract

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Although donor-specific anti-human leukocyte antigen (HLA) antibodies (DSAs) are frequently found in recipients after lung transplantation (LT), the characteristics of DSA which influence antibody-mediated rejection (AMR) in LT are not fully defined. We retrospectively analyzed 206 consecutive LT patients of our center (2010–2013). DSAs were detected by using luminex single antigen beads assay and mean fluorescence intensity was assessed. Within the study population, 105 patients had positive DSA. Patients with and without AMR (AMRPos, n = 22, and AMRNeg, n = 83, respectively) were compared. AMRPos patients had significantly greater frequencies of anti-HLA DQ DSA (DQ DSA) than AMRNeg patients (95 vs 58%, respectively, p < 0.0001). Compared to AMRNeg patients, AMRPos patients had higher DQ DSA sum MFI [7,332 (2,067–10,213) vs 681 (0–1,887), p < 0.0001]. DQ DSA when associated with AMR, had more frequent graft loss and chronic lung allograft dysfunction (CLAD). These data suggest (i) that DSA characteristics clearly differ between AMRPos and AMRNeg patients and (ii) the deleterious impact of DQ DSA on clinical outcome.

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