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Circulating anti-human leukocyte antigen IgM antibodies as a potential early predictor of allograft rejection and a negative clinical outcome after lung transplantation

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Abstract

Purpose

Anti-human leukocyte antigen (HLA) immunoglobulin (Ig) M production stimulated by an alloantigen is sensitive, making IgM a novel potential marker of allorejection after organ transplantation. This study examined the relationship between the serum levels of anti-HLA IgM early after clinical lung transplantation (LTx) and the post-transplant outcomes.

Methods

Thirty-one consecutive patients who underwent deceased LTx were included. Immunoreactivity against HLA was retrospectively analyzed by measuring the anti-HLA IgM levels in the serum sampled for the first 14 days after LTx. The flow panel reactive antibody technique was used. The ratio of the anti-class I IgM level at each day to baseline was obtained, and the peak IgM level was determined for each case. The correlation between the peak IgM level and subsequent development of acute rejection (AR), chronic lung allograft dysfunction (CLAD), and survival outcomes were examined.

Results

The peak IgM level was a significant risk factor for AR within 90 days in univariate and multivariate analyses. In the long term, the patients with positive IgM (peak level > 1.8) tended to have a poorer CLAD-free and overall survival than those with negative IgM.

Conclusion

Elevation of anti-HLA IgM levels early after LTx may be correlated with a higher incidence of rejection and negative clinical outcomes.

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Acknowledgements

This research was supported by a Grant-in-Aid for Scientific Research C (Grant numbers: 17K10785 and 20K0917602). The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Kazuaki Miyahara, Kentaroh Miyoshi, Shinji Otani, Seiichiro Sugimoto, Masaomi Yamane & Shinichi Toyooka

  2. Organ Transplant Center, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Takeshi Kurosaki, Seiichiro Sugimoto & Shinichi Toyooka

Authors
  1. Kazuaki Miyahara
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  2. Kentaroh Miyoshi
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  4. Shinji Otani
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  5. Seiichiro Sugimoto
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  6. Masaomi Yamane
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  7. Shinichi Toyooka
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Contributions

KM: data collection and analyses, statistical analyses, and drafting article; KM: clinical practice, concept/design, data interpretation, and drafting and revising the article; TK, SO, and SS: clinical practice and data collection; MY: clinical practice, data collection, and critical revision of the article; ST: clinical practice, data interpretation, and critical revision of the article.

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Correspondence to Kentaroh Miyoshi.

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Kazuaki Miyahara and other co-authors have no conflicts of interest.

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Miyahara, K., Miyoshi, K., Kurosaki, T. et al. Circulating anti-human leukocyte antigen IgM antibodies as a potential early predictor of allograft rejection and a negative clinical outcome after lung transplantation. Surg Today 52, 52–60 (2022). https://doi.org/10.1007/s00595-021-02293-7

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  • DOI: https://doi.org/10.1007/s00595-021-02293-7

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