Hayes Don, Kopp Benjamin T, Sheikh Shahid I, Shell Richard D, Paul Grace R, McConnell Patrick I, Tobias Joseph D, Tumin Dmitry
Department of Pediatrics, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Department of Surgery, The Ohio State University, College of Medicine, Columbus, Ohio, United States.
Thorac Cardiovasc Surg. 2017 Jan;65(1):36-42. doi: 10.1055/s-0036-1588058. Epub 2016 Sep 5.
Pre-lung transplant (LTx) panel reactive antibody (PRA) levels are associated with adverse outcomes in adult LTx recipients, but their impact in pediatric LTx recipients is unknown. The United Network for Organ Sharing registry was queried from 2004 to 2013 to compare survival between pediatric LTx recipients with PRA class I and II levels = 0 versus > 0. Overall, 333 pediatric LTx recipients had data on class I or II PRA and were included in the analysis. Univariate analysis demonstrated that PRA > 0 was not associated with survival benefit for class I (hazard ratio [HR] = 0.985; 95% confidence interval [CI]: 0.623, 1.555; = 0.947) or class II (HR = 1.080; 95% CI: 0.657, 1.774; = 0.762) PRA. Multivariate Cox models confirmed no significant association with mortality hazard for both class I (HR = 1.230; 95% CI: 0.641, 2.363; = 0.533) and class II (HR = 0.847; 95% CI: 0.359, 1.997; = 0.704) PRA. Multivariate logistic regression models identified no association between class I or class II and acute rejection within 3 years of LTx. Pretransplant class I and II PRA levels > 0 were not associated with mortality or acute rejection in pediatric LTx recipients.
肺移植前（LTx）群体反应性抗体（PRA）水平与成年肺移植受者的不良预后相关，但其对小儿肺移植受者的影响尚不清楚。查询了器官共享联合网络登记处2004年至2013年的数据，以比较I类和II类PRA水平=0与>0的小儿肺移植受者的生存率。总体而言，333名小儿肺移植受者有I类或II类PRA数据并纳入分析。单因素分析表明，PRA>0与I类（风险比[HR]=0.985；95%置信区间[CI]：0.623，1.555；P=0.947）或II类（HR=1.080；95%CI：0.657，1.774；P=0.762）PRA的生存获益无关。多变量Cox模型证实，I类（HR=1.230；95%CI：0.641，2.363；P=0.533）和II类（HR=0.847；95%CI：0.359，1.997；P=0.704）PRA与死亡风险均无显著关联。多变量逻辑回归模型未发现I类或II类与肺移植后3年内急性排斥反应之间存在关联。移植前I类和II类PRA水平>0与小儿肺移植受者的死亡率或急性排斥反应无关。
