Comparison of De Novo Donor-Specific Anti-HLA Antibodies (DSAs) Between Living-Donor Lobar Lung Transplantation and Cadaveric Lung Transplantation

Purpose The impact of de novo donor-specific anti-HLA antibodies (DSA) on patients after lung transplantation remains controversial. We investigated various characteristics of de novo DSAs, such as timing of initial de novo DSA detection, its duration of existence, and its type of HLA classes, in living-donor lobar lung transplantation (LDLLT) and cadaveric lung transplantation (CLT) at a single institution in Japan. Methods We performed 88 LDLLTs and 113 CLTs at Kyoto University between 2008 and 2018. We experienced the first case of antibody-mediated rejection in 2010 (Chen F, et al. Surg Today 2012 and Transplant Int 2014). Since July 2010, anti-HLA antibodies had been prospectively screened periodically, using LAB Screen Mixed (One Lambda, CA, USA). In addition, they were also investigated when recipients presented symptoms or abnormal findings. When anti-HLA antibodies were detected, their specificities were identified using LAB Screen Single Antigen (One Lambda, CA, USA). Patients’ records were retrospectively reviewed. Patients, in whom anti-HLA antibodies were measured both preoperatively and postoperatively, were included in this study. Patients who had preformed DSA were excluded from this study. Results 69 patients in LDLLT and 89 patients in CLT were included in this study. 20 patients (13%) had de novo DSAs. There were 3 patients in LDLLT (5%) and 17 patients in CLT (18%, p Conclusion We found that de novo DSAs were significantly more frequently detected in LDLLT than in CLT. Types and existing duration of de novo DSA seemed different between LDLLT than CLT.