Access this content:



Antibody (DSA) after lung transplantation (LuT) has been observed frequently with de novo Non-DSA (dN-DSA) HLA antibody. This study investigates the deleterious role of post-LuT NHAuAb and dN-DSA synergism to DSA in allograft damage.


We retrospectively analyzed NHAuAb and de novo DSA (dDSA)/dN-DSA data collected from the recipients who underwent LuT during 2012-2016. NHAuAbs were detected using LABScreenTM Autoantibody (>95% non-sensitized subjects as cut-off). HLA antibody was tested by LABScreenTM SAB (MFI≥ 1000 as cut-off). Clinical Antibody Mediated Rejection (cAMR, with acute graft dysfunction) and Chronic Lung Allograft Dysfunction (CLAD) were assessed for LuT outcomes. Results: CXCL9, AURKA, REG3A, IFNg, FLRT2, GDNF, HNRNPK, CXCL10, PLA2R, andCollagen IV detected from 111 patients’ sera drawn at DSA peak phase showed significant association to total AMR, but only FLRT2 (P<0.001), GDNF, and CXCL10 (P<0.05) were remarkably correlated to cAMR (Table 1a). Preformed & persistent LG3, PECR, PKC-Z (P<0.001) and de novo ENO1, GAPDH, Lamin-B, TubulinA1B (p<0.05) identified from 113 patients’ sera drawn around CLAD time, demonstrated strong correlation to the occurrence of CLAD (Table 1b). Patients with dDSA & dN-DSA had significantly higher incidence of cAMR than the patients with only dDSA (p<0.001, Table 1c).


Distinct clinical phases presented specific NHAuAb prof iles. Multiple NHAuAbs, especially LG3, PKC-Z, and PECR which were preformed & persistent, promoted chronic graft dysfunction. HLA-dDSA augmented by dN-DSA (most likely through shared targeting epitopes) and NHAuAbs of FLRT2, GDNF, and CXCL10 were related to acute graft injury. These HLA and non-HLA humoral risk factors warrant timely enhanced immune therapy to prevent final allograft failure.

The articles include uses of tremoflo products or describes research devices that may not have been cleared by FDA

Vasileva A, Hanafi N, Matelski J, Wu J, DeHaas E, Huang Q, et al. Intra-Subject Variance of Respiratory Oscillometry Reflects Graft Injury and is Associated with Acute Rejection and Chronic Lung Allograft Dysfunction (CLAD) Post Lung Transplant (LTx). J Hear Lung Transplant [Internet]. 2021 Apr 1 [cited 2021 Mar 22];40(4):S57

Contact us
Learn how THORASYS can help you in your practice. Fill in the form and one of our representatives will get in touch with you.
Form submitted successfully!
We'll get back to you shortly.