Hyperacute rejection after lung transplantation caused by undetected low-titer anti-HLA antibodies.
Hyperacute rejection is an early complication of transplantation, caused by the presence in the recipient of pre-formed donor-directed antibodies (Ab). We report a case of fatal early graft dysfunction after lung transplantation in a female recipient with no anti-HLA Ab detected before transplantation. Further immunologic studies revealed the presence, in the pre-transplant serum, of low-titer anti-HLA Ab directed against the donor's HLA, detectable only by flow-cytometry screening for panel-reactive antibodies. This observation emphasizes the importance of sensitive Ab detection in patients awaiting lung transplantation. Women should be specifically targeted for such sensitive Ab detection.
Masson
Emeline
E
Inserm U 645, Université de Franche-Comté, Besançon, France.
Stern
Marc
M
Chabod
Jacqueline
J
Thévenin
Chantal
C
Gonin
François
F
Rebibou
Jean-Michel
JM
Tiberghien
Pierre
P
D000208:Acute Disease; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005434:Flow Cytometry; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D016040:Lung Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000601:surgery* / Q000628:therapy
D006680:HLA Antigens; D007518:Isoantibodies