80-P

Abstract

Aim The development of DSA after lung transplantation has been implicated in acute and chronic rejection. However, the association between DSA and histological findings on lung biopsies remain unclear. In this study we investigate the association between development of DSA and lung biopsy findings. Methods We retrospectively analyzed the records of 85 lung transplant recipients (53 males, 32 females, mean age at transplant 55.5, age range 20-70) who had for-cause post-transplant monitoring for DSA performed using single antigen Luminex assay (One Lambda, Canoga Park, CA). All recipients had protocol bronchial biopsies at 2 weeks, 1, 3, and 6 months, at 1 year and for cause thereafter. We attempted to correlate de novo DSA with the following histological findings: C4d staining, acute rejection ⩾ISHLT grade 2A, and acute lung injury (ALI). Results 25 patients developed de novo DSA (29%), of those 4 had HLA class I DSA, 18 had class II, and 3 had both class I and II. The average post-transplant day for detection of class I DSA was 166 (range: 6-528) and 296 for class II (range: 6-790). The distribution of histological findings in patients with and without DSA is shown in Table 1 . In this cohort, we did not observe an appreciable difference in the mean graft survival among patients with and without DSA (600 vs. 606, respectively). Conclusions These data suggest that the development de novo DSA following lung transplant are significantly associated with histological changes and warrant further prospective systematic investigation of the temporal association between DSA and these findings.