title: Humoral Human Lung Allograft Rejection by Tissue-Restricted Non-HLA Antibodies.
abstract: A third of lung recipients have preexisting antibodies against nonhuman leukocyte self-antigens (nHAbs) present in the lung tissue. These nHAbs also form de novo in about 70% of patients within 3 years after transplantation. Both preexisting and de novo nHAbs can cause murine lung allograft dysfunction. However, their role in human transplantation remains unclear. We report hyperacute rejection after right lung transplant in a recipient with preexisting nHAbs. The recipient of the left lung from the same donor had an uneventful initial course, but de novo nHAbs developed at 3 weeks, leading to acute humoral rejection. Both patients were successfully treated with antibody-directed therapies.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Ramiro
authors.initials: R
authors.lastname: Fernandez
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Stephen
authors.initials: S
authors.lastname: Chiu
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Kirtee
authors.initials: K
authors.lastname: Raparia
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Puneet
authors.initials: P
authors.lastname: Garcha
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Carol
authors.initials: C
authors.lastname: Farver
authors.affiliation: Cleveland Clinic Foundation, Cleveland, Ohio.
authors.forename: Marie
authors.initials: M
authors.lastname: Budev
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Anat R
authors.initials: AR
authors.lastname: Tambur
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Malcolm M
authors.initials: MM
authors.lastname: DeCamp
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Scott
authors.initials: S
authors.lastname: Budinger
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Harris
authors.initials: H
authors.lastname: Perlman
authors.affiliation: Washington University School of Medicine, Saint Louis, Missouri.
authors.forename: T
authors.initials: T
authors.lastname: Mohanakumar
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: abharat@nm.org.
authors.forename: Ankit
authors.initials: A
authors.lastname: Bharat
mesh_terms: D000368:Aged; D064591:Allografts; D001323:Autoantibodies / Q000276:immunology*; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D007167:Immunotherapy / Q000379:methods*; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens