title: Pre-transplant Panel Reactive Antibody and Survival in Adult Cystic Fibrosis Patients After Lung Transplantation.
abstract: Survival implications of pre-transplant antibodies to human leukocyte antigens prior to lung transplantation (LTx) in adult cystic fibrosis (CF) patients are unknown.
  
  
  
  Data from the United Network for Organ Sharing Registry (1987-2013) were used to compare survival differences in adult CF patients with pre-transplant class I and II panel reactive antibody (PRA) levels ≤10 versus >10 %.
  
  
  
  Of 3149 CF LTx recipients, 1526 and 1399 were included in univariate survival analyses of class I and II PRA, respectively, while 1106 and 1001 were included in multivariate Cox analyses for class I and class II, respectively. Kaplan-Meier survival functions failed to demonstrate significant differences in survival with PRA >10 % for class I (Log-rank test: χ (2) (df = 1): 1.11, p = 0.293) or class II (Log-rank test: χ (2) (df = 1): 0.99, p = 0.320). Adjusting for covariates, multivariate Cox models demonstrated that class II PRA >10 % was associated with a significant increase in mortality hazard (HR 1.918; 95 % CI 1.128, 3.261; p = 0.016), whereas class I PRA >10 % was uncorrelated with this outcome.
  
  
  
  Pre-transplant PRA class II >10 % in adult CF patients is associated with elevated mortality hazard after LTx.
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA. hayes.705@osu.edu.|Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH, USA. hayes.705@osu.edu.|The Ohio State University, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. hayes.705@osu.edu.
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.affiliation: Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.|Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tumin
authors.affiliation: Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.|Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tobias
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood*; D003550:Cystic Fibrosis / Q000601:surgery*; D005260:Female; D015395:Histocompatibility Antigens Class I / Q000276:immunology*; D000949:Histocompatibility Antigens Class II / Q000276:immunology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016040:Lung Transplantation / Q000401:mortality*; D008297:Male; D057234:Preoperative Period; D016016:Proportional Hazards Models; D012042:Registries; D015996:Survival Rate; D014019:Tissue Donors; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D000906:Antibodies; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II
keywords: Adult; Cystic fibrosis; Human leukocyte antigen; Lung transplantation; Panel reactive antibody; Survival