Pretransplant Panel Reactive Antibodies and Lung Transplant Outcomes in Children.
BackgroundPre-lung transplant (LTx) panel reactive antibody (PRA) levels are associated with adverse outcomes in adult LTx recipients, but their impact in pediatric LTx recipients is unknown.MethodsThe United Network for Organ Sharing registry was queried from 2004 to 2013 to compare survival between pediatric LTx recipients with PRA class I and II levels = 0 versus > 0.ResultsOverall, 333 pediatric LTx recipients had data on class I or II PRA and were included in the analysis. Univariate analysis demonstrated that PRA > 0 was not associated with survival benefit for class I (hazard ratio [HR] = 0.985; 95% confidence interval [CI]: 0.623, 1.555;p= 0.947) or class II (HR = 1.080; 95% CI: 0.657, 1.774;p= 0.762) PRA. Multivariate Cox models confirmed no significant association with mortality hazard for both class I (HR = 1.230; 95% CI: 0.641, 2.363;p= 0.533) and class II (HR = 0.847; 95% CI: 0.359, 1.997;p= 0.704) PRA. Multivariate logistic regression models identified no association between class I or class II and acute rejection within 3 years of LTx.ConclusionsPretransplant class I and II PRA levels > 0 were not associated with mortality or acute rejection in pediatric LTx recipients.
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Don
D
Hayes
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Benjamin T
BT
Kopp
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Shahid I
SI
Sheikh
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Richard D
RD
Shell
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Grace R
GR
Paul
Department of Surgery, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Patrick I
PI
McConnell
Center for Pediatric Transplant Research, Nationwide Children's Hospital, Columbus, Ohio, United States.
Joseph D
JD
Tobias
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Dmitry
D
Tumin
D000208:Acute Disease; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006085:Graft Survival; D006648:Histocompatibility; D006650:Histocompatibility Testing; D006801:Humans; D007518:Isoantibodies / Q000097:blood*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D016040:Lung Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D009927:Tissue and Organ Procurement; D016896:Treatment Outcome; D014481:United States
D015415:Biomarkers; D007518:Isoantibodies