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DQA1 eplet mismatch load as an independent risk factor of CLAD after lung transplantation

Abstract: Lung transplantation remains the treatment of choice for end-stage lung diseases, and recipient selection is currently based on clinical urgency, ABO compatibility, and donor size. The risk of allosensitization is classically based on HLA mismatch, but eplet mismatch load is increasingly seen to be important in long-term outcomes in solid organ transplantation. Chronic lung allograft dysfunction (CLAD) is relatively common and relevant, affecting almost 50% of patients 5 y after transplantation and being the first cause of death from the first year after transplantation. The overall class-II eplet mismatch load has been associated with CLAD development. Methods: Based on clinical data, 240 lung transplant recipients were eligible for CLAD, and HLA and eplet mismatch was analyzed using the HLAMatchmaker 3.1 software. Results: A total of 92 (38.3%) lung transplant recipients developed CLAD. The time free-of-CLAD was significantly decreased in patients with presence of DQA1 eplet mismatches (P = 0.015). Furthermore, when other previously described CLAD risk factors were studied in a multivariate analysis, the presence of DQA1 eplet mismatches was found to be independently associated with the early onset of CLAD. Conclusions: The concept of epitope load has arisen as a new tool to better define donor-recipient immunologic compatibility. The presence of DQA1 eplet mismatches potentially would increase the likelihood of developing CLAD.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Transplantation Direct, 2023, 9, e1513

Editorial: Wolters Kluwer

 Año de publicación: 2023

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

 DOI: 10.1097/TXD.0000000000001513

ISSN: 2373-8731

Autoría

ELENA GONZALEZ LOPEZ

VÍCTOR MANUEL MORA CUESTA

ROA-BAUTISTA, ADRIEL

COMINS-BOO, ALEJANDRA

RENALDO, ANDRÉ

JUAN IRURE VENTURA

DAVID ITURBE FERNANDEZ

TELLO-MENA, SANDRA

DAVID SAN SEGUNDO ARRIBAS