Clinical predictors for restrictive allograft syndrome: A nested case-control study.

Summary

According to the abstract, 69 patients with restrictive allograft syndrome (RAS) were compared with 69 matched non-CLAD controls in a retrospective nested case-control analysis. Patients with RAS had higher blood eosinophils (p = 0.02), increased bronchoalveolar eosinophils (p < 0.001) and lymphocytes (p = 0.03), and a higher incidence of infections, in particular Pseudomonas species infection (p = 0.003), invasive fungal disease (p < 0.001, mainly Aspergillus species), SARS-CoV-2 (p < 0.001) and cytomegalovirus infection (p = 0.04). Anti-HLA antibodies, especially persistent donor-specific antibodies (p < 0.001) against HLA-DQ and HLA-DR, and antibody-mediated rejection (p < 0.001) were strongly associated with later RAS. Histopathologic lung injury patterns on transbronchial biopsy (p < 0.001) and persistent chest CT opacities without pulmonary dysfunction (p < 0.001) were identified as early indicators. The authors suggest that proactive detection of these factors could help limit decline. The design shows association only. The PubMed affiliations name the Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven.

Details

doi

10.1016/j.ajt.2025.01.036

pmid

39892791

authors

Beeckmans H, Kerckhof P, Acet Öztürk N, Zajacova A, Van Slambrouck J, Bos S, Vermant M, Van Dieren LO, Goeminne T, Vandervelde C, Bardyn J, Willems E, Lauriers S, Brusselmans M, Langenhoven LV, Emonds MP, De Pelsmaeker S, Kerkhofs J, Sadeleer L, Godinas L, Dupont LJ, Raemdonck DEV, Ceulemans LJ, Vanaudenaerde BM, Vos R

journal

American Journal of Transplantation

year

2025

volume

25

issue

6

pages

1319-1338

Sources and links

• Publisher record via DOI (primary)
• PubMed 39892791

Related

Links from this record

• discusses: Restrictive allograft syndrome (RAS)
• supports: Humoral (antibody-mediated) alloimmunity
• related to: Microbial dysbiosis
• affiliation named in PubMed record (BREATHE): KU Leuven BREATHE (Laboratory of Respiratory Diseases and Thoracic Surgery)

Linked from (derived)

• supports: Bronchoalveolar lavage: cell counts, microbiology and protein markers
• supports: Chest CT: parenchymal patterns and density in CLAD
• supports: HLA donor-specific antibody and non-HLA antibody testing
• supports: Transbronchial biopsy: histology and transcript-based classifiers
• supports: Airway colonisation: Pseudomonas and fungal infection
• supports: Antibody-mediated rejection and donor-specific antibodies
• supports: Cytomegalovirus and respiratory infection
• author: Bart Vanaudenaerde
• author: Robin Vos

Known gaps in this record

• full text not read (abstract only)
• funding statement and grant numbers
• full author affiliations (only the PubMed affiliation text was checked for named centres)