Lung Transplantation and the Era of the Sensitized Patient

Front Immunol. 2021 May 26:12:689420. doi: 10.3389/fimmu.2021.689420. eCollection 2021.

Abstract

Long term outcomes in lung transplant are limited by the development of chronic lung allograft dysfunction (CLAD). Within the past several decades, antibody-mediated rejection (AMR) has been recognized as a risk factor for CLAD. The presence of HLA antibodies in lung transplant candidates, "sensitized patients" may predispose patients to AMR, CLAD, and higher mortality after transplant. This review will discuss issues surrounding the sensitized patient, including mechanisms of sensitization, implications within lung transplant, and management strategies.

Keywords: allograft dysfunction; antibodies; immunosuppression; lung transplant; rejection.

Publication types

  • Review

MeSH terms

  • Graft Rejection / immunology*
  • Graft Rejection / mortality
  • Graft Rejection / prevention & control
  • Graft Survival
  • HLA Antigens / immunology*
  • Histocompatibility Testing
  • Histocompatibility*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Isoantibodies / blood*
  • Lung Transplantation* / adverse effects
  • Lung Transplantation* / mortality
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Transplantation Tolerance* / drug effects
  • Treatment Outcome

Substances

  • HLA Antigens
  • Immunosuppressive Agents
  • Isoantibodies