Gastroesophageal Reflux is a Risk Factor for the Development of de novo Donor Specific Antibodies after Lung Transplantation.

IF 6.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Heart and Lung Transplantation Pub Date : 2025-03-11 DOI:10.1016/j.healun.2025.03.007

Peter Bell, Jeffrey Kiernan, Rayoun Ramendra, Stella Wang, Ella Huszti, Frank D'Ovidio, Jonathan Yeung, Elliot Wakeam, Marcelo Cypel, Shaf Keshavjee, Stephen Juvet, Lianne Singer, Colleen Parker, Louis Liu, Tereza Martinu, Meghan Aversa

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Abstract

Background: Despite evidence that gastroesophageal reflux (GER) is harmful to the lung allograft, the mechanism of injury remains incompletely defined. We hypothesized that GER induces a humoral alloimmune response and examined the association between GER and de novo donor-specific antibody (DSA) development.

Methods: 508 lung transplant recipients who underwent routine pH-impedance testing at 3 months post-transplant were included. Univariable and multivariable Cox proportional hazards models were used to examine the impact of total GER events on de novo DSA development.

Results: De novo DSA were detected in 230 subjects (45%) at a median of 69 days post-transplant. The highest tertile of GER events (≥19 events) was associated with a significantly increased risk of de novo DSA development compared to the lowest tertile (HR 1.4, 95% CI 1.00-1.91, p=0.05).

Conclusion: GER is associated with de novo DSA development, which has implications for monitoring and anti-GER therapy after lung transplant.

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来源期刊

Journal of Heart and Lung Transplantation 医学-呼吸系统

CiteScore

10.10

自引率

6.70%

发文量

1667

审稿时长

69 days

期刊介绍： The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.