Evidence map›Paper›PMID 40606301›Full record

ArticleJHLT open2025

Clinical utility of 1:16 serum dilution as a predictor of response to therapeutic plasma exchange for HLA antibody-mediated rejection treatment and overall survival in lung transplant recipients: A two center study.

Mohamed Elrefaei, Tathagat Narula, Francisco Alvarez, Elizabeth A Godbey, Jasmine Kendrick, Gerard Criner, Francis C Cordova, Norihisa Shigemura, Yoshiya Toyoda, Olga Timofeeva

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In one paragraph

Article in JHLT open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohamed ElrefaeiDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL.
Tathagat NarulaDivision of Lung Failure and Transplant 2, Mayo Clinic, Jacksonville, FL.
Francisco AlvarezDivision of Lung Failure and Transplant 2, Mayo Clinic, Jacksonville, FL.
Elizabeth A GodbeyDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL.
Jasmine KendrickDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL.
Gerard CrinerDepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
Francis C CordovaDepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
Norihisa ShigemuraDepartment of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
Yoshiya ToyodaDepartment of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA.
Olga TimofeevaDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Antibody-Mediated Rejection (AMR) due to HLA donor-specific antibodies (DSA) is associated with poor outcomes in lung transplant recipients (LTR). AMR treatment using therapeutic plasma exchange (TPE) improves clinical outcomes in LTR. The objective of this study was to assess the clinical utility of 1:16 serum dilution HLA antibody test results as a predictor of response to TPE for de novo DSA (dnDSA) levels and AMR treatment in LTR. Methods: A retrospective analysis of 32 LTR diagnosed with AMR due to dnDSA and treated with TPE was performed at Mayo Clinic (n = 18) and Temple University Hospital (n = 14). HLA antibodies were detected by Luminex single antigen beads assay. Mean Fluorescence Intensity (MFI) levels were measured in undiluted and 1:16 diluted sera before the 1st and after the 5th TPE session. Statistical analysis was performed using GraphPad PRISM software. Results: Of 32 patients, 14 and 18 patients were diagnosed with early (< 3 months post-transplant) and late (6 months - 3 years post-transplant) AMR respectively. All patients, except one, had HLA Class II dnDSA (97%). In addition, 9/14 (64.2%) and 3/18 (16.6%) of LTR with early and late AMR respectively had HLA class I dnDSA. The MFI for all positive dnDSA in 1:16 diluted sera collected before 1st TPE demonstrated a significant correlation with MFI in undiluted sera collected after 5th TPE in both early (R Conclusion: The MFI of 1:16 serum dilution before 1st TPE may be utilized as a surrogate to predict response to TPE for AMR treatment and overall survival in LTR.

Indexed as

HLA antibodiesLung transplantPlasma exchangeRejectionSerum dilution

Identifiers

PMID40606301
PMCPMC12221467

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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.