Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience

Abstract Purpose Induction immunosuppression has improved the long‐term outcomes after lung transplant. This is the first report exploring the association of induction immunosuppression with the development of de novo donor‐specific human leukocyte antigen (HLA) antibodies (DSA) in lung transplant r...

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Autores principales:	Tathagat Narula, Samir Khouzam, Francisco Alvarez, David Erasmus, Zhuo Li, Yousif Abdelmoneim, Mohamed Elrefaei
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/b0e2bee13c6d4e13af1f5e1d0b3debef
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spelling	oai:doaj.org-article:b0e2bee13c6d4e13af1f5e1d0b3debef2021-11-12T19:57:14ZAntithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience2050-452710.1002/iid3.491https://doaj.org/article/b0e2bee13c6d4e13af1f5e1d0b3debef2021-12-01T00:00:00Zhttps://doi.org/10.1002/iid3.491https://doaj.org/toc/2050-4527Abstract Purpose Induction immunosuppression has improved the long‐term outcomes after lung transplant. This is the first report exploring the association of induction immunosuppression with the development of de novo donor‐specific human leukocyte antigen (HLA) antibodies (DSA) in lung transplant recipients (LTR). Methods Sixty‐seven consecutive primary LTR were followed for 3 years posttransplant. A total of 41/67 (61%) LTR‐received induction immunosuppression using a single dose of rabbit Antithymocyte Globulin (rATG; 1.5 mg/kg) within 24 h of transplant. All recipients had a negative flow cytometry crossmatch on the day of transplant. Serum samples at 1, 3, 6, and 12 months posttransplant were assessed for the presence of de novo HLA DSA. Results De novo HLA DSA were detected in 22/67 (32.8%) LTR within 1‐year posttransplant. Of these, 9/41 (21.9%) occurred in the induction therapy group and 13/26 (50%) in the noninduction group. Class II DSA were detected in 3/41 (7.3%) LTR who received induction compared to 9/26 (34.6%) LTR without induction immunosuppression (p = .005). Differences in overall survival or freedom from chronic lung allograft dysfunction rates between the two groups were not statistically significant. Conclusion Induction immunosuppression utilizing a modified regimen of single‐dose rATG is associated with a significant reduction in de novo DSA production in LTR.Tathagat NarulaSamir KhouzamFrancisco AlvarezDavid ErasmusZhuo LiYousif AbdelmoneimMohamed ElrefaeiWileyarticleImmunologic diseases. AllergyRC581-607ENImmunity, Inflammation and Disease, Vol 9, Iss 4, Pp 1418-1427 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Tathagat Narula Samir Khouzam Francisco Alvarez David Erasmus Zhuo Li Yousif Abdelmoneim Mohamed Elrefaei Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
description	Abstract Purpose Induction immunosuppression has improved the long‐term outcomes after lung transplant. This is the first report exploring the association of induction immunosuppression with the development of de novo donor‐specific human leukocyte antigen (HLA) antibodies (DSA) in lung transplant recipients (LTR). Methods Sixty‐seven consecutive primary LTR were followed for 3 years posttransplant. A total of 41/67 (61%) LTR‐received induction immunosuppression using a single dose of rabbit Antithymocyte Globulin (rATG; 1.5 mg/kg) within 24 h of transplant. All recipients had a negative flow cytometry crossmatch on the day of transplant. Serum samples at 1, 3, 6, and 12 months posttransplant were assessed for the presence of de novo HLA DSA. Results De novo HLA DSA were detected in 22/67 (32.8%) LTR within 1‐year posttransplant. Of these, 9/41 (21.9%) occurred in the induction therapy group and 13/26 (50%) in the noninduction group. Class II DSA were detected in 3/41 (7.3%) LTR who received induction compared to 9/26 (34.6%) LTR without induction immunosuppression (p = .005). Differences in overall survival or freedom from chronic lung allograft dysfunction rates between the two groups were not statistically significant. Conclusion Induction immunosuppression utilizing a modified regimen of single‐dose rATG is associated with a significant reduction in de novo DSA production in LTR.
format	article
author	Tathagat Narula Samir Khouzam Francisco Alvarez David Erasmus Zhuo Li Yousif Abdelmoneim Mohamed Elrefaei
author_facet	Tathagat Narula Samir Khouzam Francisco Alvarez David Erasmus Zhuo Li Yousif Abdelmoneim Mohamed Elrefaei
author_sort	Tathagat Narula
title	Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
title_short	Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
title_full	Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
title_fullStr	Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
title_full_unstemmed	Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience
title_sort	antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: a single‐center experience
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/b0e2bee13c6d4e13af1f5e1d0b3debef
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Antithymocyte globulin is associated with a lower incidence of de novo donor‐specific antibody detection in lung transplant recipients: A single‐center experience

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