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Elevation of Antidonor Immunoglobulin M Levels Precedes Acute Lung Transplant Rejection  Kentaroh Miyoshi, MD, Yoshifumi Sano, MD, Masaomi Yamane, MD,

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Presentation on theme: "Elevation of Antidonor Immunoglobulin M Levels Precedes Acute Lung Transplant Rejection  Kentaroh Miyoshi, MD, Yoshifumi Sano, MD, Masaomi Yamane, MD,"— Presentation transcript:

1 Elevation of Antidonor Immunoglobulin M Levels Precedes Acute Lung Transplant Rejection 
Kentaroh Miyoshi, MD, Yoshifumi Sano, MD, Masaomi Yamane, MD, Shinichi Toyooka, MD, Takahiro Oto, MD, Shinichiro Miyoshi, MD  The Annals of Thoracic Surgery  Volume 92, Issue 4, Pages (October 2011) DOI: /j.athoracsur Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Outline of the study. Donor lymphocytes were isolated from peripheral blood and incubated with recipient sera. Both immunoglobulin (Ig)M and IgG levels in recipient sera against T cells from both donor grafts were analyzed daily using flow cytometry crossmatching through the first 14 days after transplantation. Each recipient received a graft from 2 donors, and therefore, antibody monitoring of 10 recipients was performed for a total of 20 donors. The development of acute rejection in the acute rejection (AR) group is unilateral. Accordingly, we obtained data associated with acute rejection for 5 recipients. (Lt. D = left donor; LTx = lung transplantation; POD = postoperative day; NR = no rejection; R = recipient; Rt. D = right donor.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Overview of the 14-day monitoring results for (A) acute rejection group and (B) no rejection group. In each line chart, both anti-right graft antibody levels (solid line) and anti-left graft antibody levels (dashed line) are shown for each recipient. Antidonor T-cell antibody values for each posttransplant day are presented as the fold induction over the pretransplant mean channel fluorescence value. Unilateral acute rejection developed on the day indicated by the triangles. (Ig = immunoglobulin; POD = postoperative day; Pt = patient.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Mean de novo antidonor T-cell (A) immunoglobulin (Ig)M levels and (B) IgG levels during the 14 days after transplantation (PostTx) for the rejected grafts in the acute rejection (AR) group (n = 5), nonrejected grafts in the AR group (n = 5), and grafts in the no rejection (NR) group (n = 10). Data were plotted for each of the 20 donors. The IgM levels against the rejected grafts were significantly higher than those against the nonrejected grafts in the AR group (p = 0.009) and the grafts in the NR group (p = 0.010). A similar, but marginally significant at best, trend was observed for mean IgG values. (Ab = antibody.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 The serum levels of de novo antidonor T-cell antibodies, (A) immunoglobulin (Ig)M levels and (B) IgG, around the acute rejection episode in the acute rejection (AR) group (n = 5). The antibody values for rejected grafts (solid bars) are compared with those for nonrejected grafts (open bars) in the AR group during the same period (day −3 to day +3 relative to the onset of acute rejection). The IgM levels against the rejected grafts became significantly higher (asterisks) than those against nonrejected grafts 2 days before the onset of acute rejection. No remarkable increase in IgG levels against the rejected grafts was observed before acute rejection. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2011 The Society of Thoracic Surgeons Terms and Conditions

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