The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025
Gastroesophageal reflux is a risk factor for the development of de novo donor specific antibodies after lung transplantation.
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Bell Peter, Kiernan Jeffrey, Ramendra Rayoun, Wang Stella, Huszti Ella, D'Ovidio Frank, Yeung Jonathan, Wakeam Elliot, Cypel Marcelo, Keshavjee Shaf, Juvet Stephen, Singer Lianne, Parker Colleen, Liu Louis, Martinu Tereza, Aversa Meghan
Аннотация
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: Five hundred and eight 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.
METHODS: Five hundred and eight 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.