Evidence map›Paper›PMID 38951782›Full record

ArticleRespiratory research2024

Pseudomonas aeruginosa infection correlates with high MFI donor-specific antibody development following lung transplantation with consequential graft loss and shortened CLAD-free survival.

Levente Zoltán Bogyó, Klára Török, Zsuzsanna Illés, Anikó Szilvási, Bálint Székely, Anikó Bohács, Orsolya Pipek, Ildikó Madurka, Zsolt Megyesfalvi, Ferenc Rényi-Vámos and 4 more

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Article in Respiratory research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Levente Zoltán BogyóDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Klára TörökDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Zsuzsanna IllésHungarian National Blood Transfusion Service, Budapest, Hungary.
Anikó SzilvásiHungarian National Blood Transfusion Service, Budapest, Hungary.
Bálint SzékelyDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Anikó BohácsDepartment of Pulmonology, Semmelweis University, Budapest, Hungary.
Orsolya PipekDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Ildikó MadurkaDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Zsolt MegyesfalviDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Ferenc Rényi-VámosDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Balázs DömeDepartment of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.
Krisztina BogosNational Korányi Institute of Pulmonology, Koranyi Frigyes ut 1, Budapest, 1121, Hungary. bogos@koranyi.hu.
Balázs Gieszer *Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary. gieszer.balazs@oncol.hu.
Eszter Bakos *Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology, Rath Gyorgy u. 7-9, Budapest, 1122, Hungary.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDonor-specific antibodies (DSAs) are common following lung transplantation (LuTx), yet their role in graft damage is inconclusive. Mean fluorescent intensity (MFI) is the main read-out of DSA diagnostics; however its value is often disregarded when analyzing unwanted post-transplant outcomes such as graft loss or chronic lung allograft dysfunction (CLAD). Here we aim to evaluate an MFI stratification method in these outcomes.

methodsA cohort of 87 LuTx recipients has been analyzed, in which a cutoff of 8000 MFI has been determined for high MFI based on clinically relevant data. Accordingly, recipients were divided into DSA-negative, DSA-low and DSA-high subgroups. Both graft survival and CLAD-free survival were evaluated. Among factors that may contribute to DSA development we analyzed Pseudomonas aeruginosa (P. aeruginosa) infection in bronchoalveolar lavage (BAL) specimens.

resultsHigh MFI DSAs contributed to clinical antibody-mediated rejection (AMR) and were associated with significantly worse graft (HR: 5.77, p < 0.0001) and CLAD-free survival (HR: 6.47, p = 0.019) compared to low or negative MFI DSA levels. Analysis of BAL specimens revealed a strong correlation between DSA status, P. aeruginosa infection and BAL neutrophilia. DSA-high status and clinical AMR were both independent prognosticators for decreased graft and CLAD-free survival in our multivariate Cox-regression models, whereas BAL neutrophilia was associated with worse graft survival.

conclusionsP. aeruginosa infection rates are elevated in recipients with a strong DSA response. Our results indicate that the simultaneous interpretation of MFI values and BAL neutrophilia is a feasible approach for risk evaluation and may help clinicians when to initiate DSA desensitization therapy, as early intervention could improve prognosis.

Indexed as

Graft RejectionLung TransplantationPseudomonas aeruginosaPseudomonas InfectionsAdultAgedCohort StudiesFemaleGraft SurvivalHumansIsoantibodiesMaleMiddle AgedRetrospective StudiesTissue DonorsIsoantibodiesAMRBALCLADDSAHLALung transplantationPseudomonas aeruginosa

Identifiers

PMID38951782
PMCPMC11218249

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.