{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:22:56Z","timestamp":1789233776908,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,3,5]],"date-time":"2017-03-05T00:00:00Z","timestamp":1488672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antibody\u2010mediated rejection (<jats:styled-content style=\"fixed-case\">AMR<\/jats:styled-content>) resulting from de novo donor\u2010specific antibodies (dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>) leads to adverse outcomes following heart transplantation (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x). It remains unclear what role dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> to specific <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content> antigens play in adverse outcomes. This study compares outcomes in patients developing dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> to <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> antigens with those developing non\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> and those free from dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present study was a single\u2010center, retrospective analysis of 122 consecutive <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x recipients. The primary outcome was a composite of death or graft dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After 3.3\u00a0years of follow\u2010up, 31 (28%) patients developed dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>. Mean time to dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> was 539\u00a0days. Of 31 patients, 19 developed <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> antibodies and 12 developed non\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> antibodies. Compared to non\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> DQ<\/jats:styled-content> antibodies presented with higher <jats:styled-content style=\"fixed-case\">MFI<\/jats:styled-content> values (<jats:italic>P<\/jats:italic>=.001) were more likely persistent (<jats:italic>P<\/jats:italic>=.001) and appeared later post\u2010<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x (654 vs 359\u00a0days, <jats:italic>P<\/jats:italic>=.035). In a multivariable analysis, <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> was associated with increased risk of the primary endpoint (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 6.15, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.57\u201014.75, <jats:italic>P<\/jats:italic>=.001), whereas no increased risk was seen with non\u2010<jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> (<jats:italic>P<\/jats:italic>=.749).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>dn<jats:styled-content style=\"fixed-case\">DSA<\/jats:styled-content> to <jats:styled-content style=\"fixed-case\">DQ<\/jats:styled-content> antigens following <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>x are associated with increased risk of death and graft dysfunction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.12924","type":"journal-article","created":{"date-parts":[[2017,2,9]],"date-time":"2017-02-09T08:03:30Z","timestamp":1486627410000},"source":"Crossref","is-referenced-by-count":24,"title":["De novo <scp>DQ<\/scp> donor\u2010specific antibodies are associated with worse outcomes compared to non\u2010<scp>DQ<\/scp> de novo donor\u2010specific antibodies following heart transplantation"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0889-9711","authenticated-orcid":false,"given":"Robert Townsend","family":"Cole","sequence":"first","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Emory University Department of Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Bray","sequence":"additional","affiliation":[{"name":"Emory University Department of Pathology and Laboratory Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard M.","family":"Gebel","sequence":"additional","affiliation":[{"name":"Emory University Department of Pathology and Laboratory Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna","family":"Morris","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"McCue","sequence":"additional","affiliation":[{"name":"Emory University Department of Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Yin","sequence":"additional","affiliation":[{"name":"Emory University Department of Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Raja","family":"Laskar","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Book","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maan","family":"Jokhadar","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Smith","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duc","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Emory University Center for Heart Failure Therapy and Transplantation  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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