June 21, 2013

Pathologic findings in lung allografts with anti-HLA antibodies


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Antibody-mediated rejection is a well recognized cause of accelerated allograft dysfunction in heart and kidney transplantation in the setting of de novo donor specific antibodies (DSA). Development of de novo DSA in lung transplant recipients has been linked with early development of bronchiolitis obliterans syndrome (BOS), although the role of antibody-mediated rejection in BOS is still under investigation. This retrospective review of 41 lung biopsy specimens from lung transplant recipients, grouped specimens according to the presence or absence of de novo DSA, and found significant neutrophilic infiltration and/or diffuse alveolar damage was more common in patients with positive DSA. Immunohistochemistry for C3d and C4d showed no correlation with the histopathologic findings or presence of DSA.

Lung Transplantation

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