{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T08:46:42Z","timestamp":1782463602582,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HLA"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Antibodies to HLA are a major cause of chronic lung allograft dysfunction (CLAD) following lung transplantation (LTx), however mounting evidence indicates non\u2010HLA autoantibodies may also play a role. LTx recipients may have increased autoantibodies related to their native disease, and these may impact both pre\u2010transplant assays and LTx outcomes. The flow cytometry crossmatch (FXM) assay is often used peri\u2010LTx to define immunological risk; however, the presence of autoantibodies in LTx recipients may associate with positivity in the FXM, and the clinical impact of this is unknown. In a retrospective, single\u2010center cohort, we investigate the association of pre\u2010transplant non\u2010HLA autoantibodies on the FXM and subsequent CLAD. The serum of 68 LTx recipients was retrospectively tested for 39 autoantibody targets pre\u2010 and 12\u2010months post\u2010transplant. A further cohort of waitlisted LTx recipients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200925) with HLA antibody\u2010negative FXM\u2010positive sera was evaluated for the presence of these same 39 autoantibodies to determine the association of autoantibodies and FXM reactivity. CLAD status and freedom from CLAD were defined and analysed for all recipients. MFI strengths in five autoantibody targets associated with FXM positivity when compared to the HLA donor\u2010specific and FXM negative patients. LTx recipients who were positive to \u2265\u20098 non\u2010HLA autoantibodies had an increased risk of CLAD (HR\u2009=\u20093.09\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01) and a decreased freedom from CLAD (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). Recipients with increased positivity to non\u2010HLA autoantibodies pre\u2010LTx demonstrate increased risk of CLAD and decreased freedom from CLAD. Furthermore, the strength of these autoantibodies is associated with FXM positivity in the absence of HLA antibodies. Further research with larger cohorts is required to better understand which autoantibody targets are responsible for CLAD outcomes, and to define best cut\u2010offs to define reactivity.\n                  <\/jats:p>","DOI":"10.1111\/tan.70786","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T07:28:50Z","timestamp":1780644530000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010HLA Autoantibodies Associate With a Positive Flow\u2010Crossmatch Pre\u2010 and Chronic Lung Allograft Dysfunction Post\u2010 Lung Transplant"],"prefix":"10.1111","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3732-3383","authenticated-orcid":false,"given":"Steven","family":"Hiho","sequence":"first","affiliation":[{"name":"Lung Transplant Service, Department of Respiratory Medicine Alfred Hospital and Monash University  Melbourne Australia"},{"name":"Australian Red Cross LifeBlood Victorian Transplantation and Immunogenetics Service  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Paporakis","sequence":"additional","affiliation":[{"name":"Australian Red Cross LifeBlood Victorian Transplantation and Immunogenetics Service  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadiaa","family":"Rahman","sequence":"additional","affiliation":[{"name":"Australian Red Cross LifeBlood Victorian Transplantation and Immunogenetics Service  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Levvey","sequence":"additional","affiliation":[{"name":"Lung Transplant Service, Department of Respiratory Medicine Alfred Hospital and Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Diviney","sequence":"additional","affiliation":[{"name":"Australian Red Cross LifeBlood Victorian Transplantation and Immunogenetics Service  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Snell","sequence":"additional","affiliation":[{"name":"Lung Transplant Service, Department of Respiratory Medicine Alfred Hospital and Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Lung Transplant Service, Department of Respiratory Medicine Alfred Hospital and Monash University  Melbourne Australia"},{"name":"Department of Microbiology and Immunology University of Melbourne at the Peter Doherty Institute for Infection and Immunity  Melbourne Australia"},{"name":"Australian Red Cross LifeBlood South Australian Transplantation and Immunogenetics Service  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Westall","sequence":"additional","affiliation":[{"name":"Lung Transplant Service, Department of Respiratory Medicine Alfred Hospital and Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.07.85"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000753"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01248-2017"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/tan.12626"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001389"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2023.12.007"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2019.02.006"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/ars.2017.7382"},{"issue":"5","key":"e_1_2_10_10_1","first-page":"1","article-title":"Oxidative Biomolecular Damage: A Possible Mechanism for Systemic Autoimmunity","volume":"13","author":"Rasheed N.","year":"2019","journal-title":"International Journal of Health Sciences"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2010.06.009"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.06.003"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2016.08.009"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2017.12.001"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2353\/ajpath.2007.060728"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2004.12.043"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.111.250431"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.169.3.1542"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2018.08.001"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2016.04.014"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/tan.14613"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humimm.2017.10.020"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2020.04.012"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI28031"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13487"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04079.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003005"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2010111183"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12592"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.05.025"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.12306"}],"container-title":["HLA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tan.70786","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tan.70786","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tan.70786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:59:43Z","timestamp":1782460783000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tan.70786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/tan.70786"],"URL":"https:\/\/doi.org\/10.1111\/tan.70786","archive":["Portico"],"relation":{},"ISSN":["2059-2302","2059-2310"],"issn-type":[{"value":"2059-2302","type":"print"},{"value":"2059-2310","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70786"}}