Abstract:
BACKGROUND:Survival implications of pre-transplant antibodies to human leukocyte antigens prior to lung transplantation (LTx) in adult cystic fibrosis (CF) patients are unknown. METHODS: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 %. RESULTS: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. CONCLUSIONS:Pre-transplant PRA class II >10 % in adult CF patients is associated with elevated mortality hazard after LTx.
journal_name
Lungjournal_title
Lungauthors
Hayes D Jr,Tumin D,Tobias JDdoi
10.1007/s00408-016-9861-8subject
Has Abstractpub_date
2016-06-01 00:00:00pages
429-35issue
3eissn
0341-2040issn
1432-1750pii
10.1007/s00408-016-9861-8journal_volume
194pub_type
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