Association between SARS-CoV-2 infection and de novo HLA donor specific antibody production in lung transplant recipients: single-center study
Mohamed Elrefaei1, Sadia Z. Shah2, Yousif Abdelmoneim1, Si M. Pham3.
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, United States; 2Department of Transplantation, Mayo Clinic, Jacksonville, FL, United States; 3Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, United States
Introduction: COVID-19 pandemic has led to significant morbidity and mortality in lung transplant recipients. Respiratory viral infections may be associated with de-novo HLA donor-specific antibody production and impacting lung transplant outcome.
Methods: Since one of the immunomodulation strategies post-SARS-CoV-2 infection in lung transplant recipients include decreasing or holding anti-metabolites, concerns have been raised for higher incidence of de-novo HLA donor specific antibody production in lung transplant recipients. We performed a retrospective chart review of 24 consecutive lung transplant recipients diagnosed with COVID-19 to investigate this concern.
Results: We observed no significant association between SARS-CoV-2 infection and immunomodulation on pre-existing or de novo HLA donor specific antibodies.
Conclusion: SARS-CoV-2 infection was not associated with a significant increase in de-novo HLA DSA production or MFI levels of pre-existing HLA DSA compared to pre-COVID-19 diagnosis in lung transplant recipients. These results provide a valuable insight on the effects of SARS-CoV-2 infection on immunogenicity in lung transplant recipients.
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