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Severe SARS-CoV-2 infection is associated with increased risk of De novo HLA antibody production in lung transplant recipients: Single-center study

  • 0Department of Transplantation, Mayo Clinic, Jacksonville, FL, United States of America.
Transplant Immunology +

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December 7, 2024

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December 7, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Severe COVID-19 in lung transplant recipients (LTR) may increase the risk of developing de novo HLA donor-specific antibodies (DSA). This finding is crucial for understanding post-transplant complications and managing LTR during the pandemic.

Area Of Science

  • Immunology
  • Transplantation
  • Infectious Diseases

Background

  • COVID-19 poses significant risks to lung transplant recipients (LTR), potentially increasing morbidity and mortality.
  • Respiratory viral infections, including SARS-CoV-2, may trigger de novo HLA donor-specific antibody (DSA) production, impacting transplant outcomes.
  • Concerns exist regarding increased DSA incidence in LTR due to immunomodulatory strategies like reducing anti-metabolites post-SARS-CoV-2 infection.

Purpose Of The Study

  • To investigate the association between COVID-19 severity and de novo HLA DSA production in lung transplant recipients.
  • To evaluate the impact of SARS-CoV-2 infection on HLA DSA development and persistence in LTR.

Main Methods

  • Retrospective chart review of 63 consecutive LTR diagnosed with COVID-19.
  • Classification of COVID-19 severity into mild, moderate, and severe groups based on clinical criteria and oxygen requirements.
  • Comparison of CPRA and HLA DSA levels pre-COVID-19 and at 1 and 6 months post-diagnosis using Kruskal-Wallis test.

Main Results

  • No significant differences in CPRA or persistent HLA DSA were observed across mild, moderate, and severe COVID-19 groups.
  • De novo HLA DSA were detected within 6 months post-COVID-19 in 0% of mild, 2.3% of moderate, and 33.3% of severe cases (p=0.001).
  • Severe COVID-19 was significantly associated with a higher incidence of de novo HLA DSA development.

Conclusions

  • Severe COVID-19 in LTR is associated with an increased risk of de novo HLA DSA production.
  • De novo DSA development may contribute to allograft dysfunction in LTR following severe SARS-CoV-2 infection.
  • Further research is warranted to elucidate the mechanisms and clinical implications of de novo DSA in LTR post-COVID-19.

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