The serum level of de novo donor specific antibody can predict acute rejection in lung transplantation.

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There is no useful biomarkers for diagnosis of acute rejection have been clinically used after lung transplantation (LTx). In this study, daily transition of de novo donor-specific alloantibodies (DSA) was analyzed for our living-donor lobar LT ecipients to determine whether DSA levels are influenced by acute rejection. Ten non-sensitized patients who had received living donor lobar LTx by donation from two individuals were analyzed. Five of them developed unilateral acute rejection during the first 14 days after transplantation (AR+ group), and the others had no rejection episode during the period (AR- group). The immunoreactivity against T-cells from each side of donors was daily monitored by detecting donor-specific IgM using flow cytometry crossmatch technique. The difference between donor-specific IgM levels of serum from each side of donors was more remarkable in the AR+ group than in the AR- group (p<0.05). In the AR+ group, the IgM levels against the rejected donors started to be significantly higher than that ageinst he non-rejected donors from two days before the clinical onset of acute rejection (p<0.05). A greater immunoreactivity only for the rejected donor preceded the clinical onset of acute rejection. Sequential de novo donor-specic IgM monitoring can contribute the early diagnosis of acute rejection.