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Vinson AD, Rampolla-Selles R, Cooper ES, et al. Non-Human Leukocyte Antigen Antibody-Mediated Lung Transplant Rejection: The Other Anti-A. Ochsner J. 2018;18(3):260-263doi: 10.31486/toj.17.0068.
Vinson, A. D., Rampolla-Selles, R., Cooper, E. S., & Alquist, C. R. (2018). Non-Human Leukocyte Antigen Antibody-Mediated Lung Transplant Rejection: The Other Anti-A. The Ochsner journal, 18(3), 260-263. https://doi.org/10.31486/toj.17.0068
Vinson, Anthony D, et al. "Non-Human Leukocyte Antigen Antibody-Mediated Lung Transplant Rejection: The Other Anti-A." The Ochsner journal vol. 18,3 (2018): 260-263. doi: https://doi.org/10.31486/toj.17.0068
Vinson AD, Rampolla-Selles R, Cooper ES, Alquist CR. Non-Human Leukocyte Antigen Antibody-Mediated Lung Transplant Rejection: The Other Anti-A. Ochsner J. 2018;18(3):260-263. doi: 10.31486/toj.17.0068. PMID: 30275791; PMCID: PMC6162120.
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Ochsner J. 2018;18(3):260-263. doi: 10.31486/toj.17.0068.

Non-Human Leukocyte Antigen Antibody-Mediated Lung Transplant Rejection: The Other Anti-A.

The Ochsner journal

Anthony D Vinson, Reinaldo Rampolla-Selles, E Shannon Cooper, Caroline R Alquist

Affiliations

  1. Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, LA.
  2. Multi-Organ Transplant Institute, Ochsner Clinic Foundation, New Orleans, LA.
  3. Department of Pathology, Ochsner Clinic Foundation, New Orleans, LA.

PMID: 30275791 PMCID: PMC6162120 DOI: 10.31486/toj.17.0068

Abstract

BACKGROUND: Acute rejection of lung allografts is an important contributor to morbidity and mortality in the transplant patient population, resulting in the dysfunction and destruction of the graft by the host's immune system via cellular or antibody-mediated mechanisms. Acute cellular rejection (ACR) is more common and better characterized than antibody-mediated rejection, which to date lacks any widely agreed upon, standardized set of diagnostic criteria. We present a case of AMR attributable to a rare phenomenon, non-human leukocyte antigen (HLA) antibodies.

CASE REPORT: A 50-year-old male underwent an uneventful single lung transplant for pulmonary sarcoidosis. Donor and recipient blood type was A positive. No pretransplant donor-specific antibodies were identified. Flow cytometric crossmatch was negative. The postoperative course was significant for a single-unit transfusion of packed red blood cells on postoperative day (POD) 1 and persistent asymptomatic

CONCLUSION: This case highlights the clinical significance of AMR in lung allografts, as well as the need to investigate both HLA and non-HLA antibody sources in pulmonary transplant rejection refractory to treatment.

Keywords: Fatal outcome; HLA antigens; graft rejection; lung transplantation

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