HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): James J. Jaggers Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lau, C. L. Articles by Davis, R. D. Search for Related Content PubMed PubMed Citation Articles by Lau, C. L. Articles by Davis, R. D., Jr Related Collections Related Article

Ann Thorac Surg 2000;69:1520-1524
© 2000 The Society of Thoracic Surgeons

---

Original articles: General thoracic

Influence of panel-reactive antibodies on posttransplant outcomes in lung transplant recipients

^a Departments of Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
^b Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
^c Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
^d Department of Immunology, Duke University Medical Center, Durham, North Carolina, USA

Address reprint requests to Dr Davis, Department of General and Thoracic Surgery, Duke University Medical Center, Box 3864, Durham, NC 27710
e-mail: davis053{at}mc.duke.edu

Presented at the Forty-sixth Annual Meeting of the Southern Thoracic Surgical Association, San Juan, Puerto Rico, Nov 4–6, 1999.

Background. Panel-reactive antibody (PRA) is used to estimate the degree of humoral sensitization in the recipient before transplantation. Although pretransplant sensitization is associated with increased complications in other solid organ transplant recipients, less is known about the outcome of sensitized lung transplant recipients. Therefore, we sought to determine the impact of elevated pretransplant PRA on clinical outcomes after lung transplantation.

Methods. The records of the first 200 lung transplant operations performed at Duke University Medical Center were reviewed. The outcomes of sensitized patients, PRA greater than 10% before transplantation (n = 18), were compared with the outcomes of nonsensitized patients.

Results. Sensitized patients experienced a significantly greater number of median ventilator days posttransplant (9 ± 8) as compared with nonsensitized recipients (1 ± 11; p = 0.0008). There were no significant differences between the number of episodes of acute rejection; however, there was a significantly increased incidence of bronchiolitis obliterans syndrome occurring in untreated sensitized recipients (56%) versus nonsensitized (23%; p = 0.044). In addition, there was a trend towards decreased survival in the sensitized recipients, with a 2-year survival of 58% in sensitized recipients as compared with 73% in the nonsensitized patients (p = 0.31).

Conclusions. Sensitized lung transplant recipients experience more acute and chronic complications after transplantation. These patients probably warrant alternative management strategies.

Related Article

Ann. Thorac. Surg. 2000 69: 1524. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				T. Iwata, A. Philipovskiy, A. J. Fisher, R. G. Presson Jr., M. Chiyo, J. Lee, E. Mickler, G. N. Smith, I. Petrache, D. B. Brand, et al. Anti-Type V Collagen Humoral Immunity in Lung Transplant Primary Graft Dysfunction J. Immunol., October 15, 2008; 181(8): 5738 - 5747. [Abstract] [Full Text] [PDF]

				A. S. Shah, L. Nwakanma, C. Simpkins, J. Williams, D. C. Chang, and J. V. Conte Pretransplant Panel Reactive Antibodies in Human Lung Transplantation: An Analysis of Over 10,000 Patients Ann. Thorac. Surg., June 1, 2008; 85(6): 1919 - 1924. [Abstract] [Full Text] [PDF]

				L. P. Nicod Mechanisms of airway obliteration after lung transplantation. Proceedings of the ATS, July 1, 2006; 3(5): 444 - 449. [Abstract] [Full Text] [PDF]

				C. L. Lau, G. A. Patterson, and S. M. Palmer Critical Care Aspects of Lung Transplantation J Intensive Care Med, March 1, 2004; 19(2): 83 - 104. [Abstract] [PDF]

				A. Boehler and M. Estenne Post-transplant bronchiolitis obliterans Eur. Respir. J., December 1, 2003; 22(6): 1007 - 1018. [Abstract] [Full Text] [PDF]

				R. D. Davis Jr, C. L. Lau, S. Eubanks, R. H. Messier, D. Hadjiliadis, M. P. Steele, and S. M. Palmer Improved lung allograft function after fundoplication in patients with gastroesophageal reflux disease undergoing lung transplantation J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 533 - 542. [Abstract] [Full Text] [PDF]

				W. M. Chatila, S. Furukawa, J. P. Gaughan, and G. J. Criner Respiratory Failure After Lung Transplantation Chest, January 1, 2003; 123(1): 165 - 173. [Abstract] [Full Text] [PDF]

				D. Hadjiliadis, R. D. Davis, and S. M. Palmer Is Transplant Operation Important in Determining Posttransplant Risk of Bronchiolitis Obliterans Syndrome in Lung Transplant Recipients? Chest, October 1, 2002; 122(4): 1168 - 1175. [Abstract] [Full Text] [PDF]