Pre-existing non-human leukocyte antigen antibodies are associated with allograft rejection after thoracic transplantation |
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| Institution: | 1. Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;2. Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea; Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;3. Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;4. Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;5. Department of Laboratory Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;1. Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan;2. Department of Diagnostic Pathology, Graduate School of Medicine, Osaka City University, Osaka, Japan;3. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, Osaka, Japan;1. Department of General, Visceral, and Transplant Surgery, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;2. Walter-Brendel Centre of Experimental Medicine, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;3. Institute of Laboratory Medicine, LMU University Hospitals, Ludwig-Maximilians-Universität Munich, Marchioninistraße 15, 81377 Munich, Germany;1. Hospital of LMU Munich, Division of General, Visceral, Vascular and Transplant Surgery, Munich, Bavaria, Germany;2. Hospital of LMU Munich, Division of Nephrology, Department of Medicine IV, Munich, Bavaria, Germany;3. University Hospital Cologne, Department for General, Visceral, Cancer and Transplant Surgery, Cologne, North Rhine-Westphalia, Germany;1. Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;2. Department of Anatomical Sciences, Sarab Faculty of Medical Sciences, Sarab, Iran;3. Department of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran;4. Medical and molecular genetics, Ataturk University, Erzurum, Turkey;5. Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran;6. Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran;1. Department of Neurology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong Province, China;2. Department of Urology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai City, Shandong Province, China;1. Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;2. Pediatric Cell and Gene Therapy Research Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Sciences, Tehran, Iran;3. Research Center for Immunodeficiencies, Children''s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;4. Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran;5. Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran;6. Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran;7. Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;8. Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;9. Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran;10. Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran |
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| Abstract: | BackgroundThere is growing evidence on the important role of non-human leukocyte antigen (HLA) antibodies in lung and heart transplant rejection. Since data on the prevalence and clinical significance of non-HLA antibodies in the Asian population are scarce, we analyzed non-HLA antibodies in heart and lung transplant patients.MethodsWe used the Luminex method to measure non-HLA antibodies in patients who underwent heart transplantation (N = 28) or lung transplantation (N = 36) between 2016 and 2019. We evaluated the association between pre-existing non-HLA antibodies and acute rejection-free days in these recipients.ResultsOf 64 patients, 27 (42.2%) patients underwent rejection, with 26 (40.6%) acute cellular rejection and one (1.6%) acute antibody-mediated rejection. Among 33 identified different non-HLA antibodies, only the anti-glutathione S-transferase theta-1 (GSTT1) antibody positive rate was significantly higher in patients with acute rejection compared to those without rejection (14.8% vs. 0%, p = 0.016). The angiotensin II type I receptor positive rate was not significantly different between the two groups (40% vs. 18.5%, p = 0.129). In the multivariate Cox regression analysis, anti-GSTT1 antibody-positive patients had a higher risk of acute allograft rejection (hazard ratio, 4.19; 95% confidence interval CI], 1.41–12.49; p = 0.010). The Kaplan-Meier curve showed that anti-GSTT1 antibody-positive patients had fewer acute rejection-free days (χ2 = 7.892; p = 0.005). Additionally, patients who underwent platelet transfusion (odds ratio, 1.49; 95% CI, 1.16–1.91; p = 0.002) before transplantation were more likely to be positive for anti-GSTT1 antibody.ConclusionPatients with antibodies against GSTT1 before heart or lung transplantation have anincreased risk of acute rejection. |
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