{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:09:41Z","timestamp":1783944581623,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL130275"],"award-info":[{"award-number":["R01HL130275"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Highly sensitized patients with advanced lung disease, who are more often Black and Hispanic women, are at increased risk for waitlist death. In 2012, we implemented a protocol to cross any pre\u2010transplant donor\u2010specific antibody (DSA), so long as a prospective complement\u2010dependent cytotoxicity (CDC) crossmatch was negative. We report long\u2010term outcomes, including overall survival and chronic lung allograft dysfunction (CLAD)\u2010free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010institution retrospective cohort study of lung transplant recipients between October 1, 2012\u2013December 31, 2022. We compared overall retransplant\u2010free survival and CLAD\u2010free survival between recipients with and without pre\u2010formed DSA. Secondary outcomes included freedom from acute cellular rejection (ACR) and antibody\u2010mediated rejection (AMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study cohort included 427 recipients with a median duration of follow\u2010up of 4.3 years (IQR\u00a0=\u00a02.1\u20136.9). Thirty\u2010three (7.7%) recipients had pre\u2010transplant DSA with a peak historical mean fluorescence intensity (MFI) of 4200 (IQR\u00a0=\u00a03000\u20136600, total range 2100\u201323\u00a0000). The median number of DSA per patient was 1 (IQR\u00a0=\u00a01\u20132, total range 1\u20138). There was no difference in adjusted overall survival between recipients with and without pre\u2010formed DSA (HR\u00a0=\u00a01.39, 95% CI\u00a0=\u00a00.82\u20132.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.22) or adjusted CLAD\u2010free survival between recipients with and without pre\u2010formed DSA (HR\u00a0=\u00a01.07, 95% CI\u00a0=\u00a00.65\u20131.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.79). Recipients with pre\u2010formed DSA did not have increased adjusted hazard of ACR (HR\u00a0=\u00a00.71, 95% CI\u00a0=\u00a00.29\u20131.75,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.45) but did have increased adjusted hazard of AMR (HR\u00a0=\u00a05.02, 95% CI\u00a0=\u00a02.11\u201311.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this moderately\u2010sized cohort, a protocol of accepting donor offers for lung transplant candidates with pre\u2010formed DSA but negative CDC crossmatch was not associated with worse overall or CLAD\u2010free survival, within the limitations of the sample size.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70241","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T10:04:58Z","timestamp":1753265098000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long\u2010Term Chronic Lung Allograft Dysfunction\u2010Free Survival Following Lung Transplant in the Presence of Donor\u2010Specific Antibodies"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4416-6243","authenticated-orcid":false,"given":"Benjamin","family":"Grobman","sequence":"first","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Courtwright","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Yeung","sequence":"additional","affiliation":[{"name":"Division of Renal Medicine Brigham and Women's Hospital  Boston Massachusetts USA"},{"name":"Tissue Typing Lab, Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selvin","family":"Jacob","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefi","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Keshk","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Hackman","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Coppolino","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dunning","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital  Boston Massachusetts 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