Elevated Plasma Long Pentraxin‐3 Levels and Primary Graft Dysfunction After Lung Transplantation for Idiopathic Pulmonary Fibrosis

• Published in: American journal of transplantation Vol. 11; no. 11; pp. 2517 - 2522
• Main Authors: Diamond, J. M., Lederer, D. J., Kawut, S. M., Lee, J., Ahya, V. N., Bellamy, S., Palmer, S. M., Lama, V. N., Bhorade, S., Crespo, M., Demissie, E., Sonett, J., Wille, K., Orens, J., Shah, P. D., Weinacker, A., Weill, D., Kohl, B. A., Deutschman, C. C., Arcasoy, S., Shah, A. S., Belperio, J. A., Wilkes, D., Reynolds, J. M., Ware, L. B., Christie, J. D.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.11.2011; Wiley
• Subjects: Adult; Biological and medical sciences; C-Reactive Protein - metabolism; Case-Control Studies; Female; Humans; Idiopathic pulmonary fibrosis; Idiopathic Pulmonary Fibrosis - physiopathology; Idiopathic Pulmonary Fibrosis - surgery; Immunity, Innate; long pentraxin‐3; lung transplantation; Lung Transplantation - adverse effects; Lung Transplantation - physiology; Male; Medical sciences; Middle Aged; Pneumology; primary graft dysfunction; Primary Graft Dysfunction - blood; Primary Graft Dysfunction - etiology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - surgery; Reperfusion Injury - complications; Reperfusion Injury - immunology; Respiratory system : syndromes and miscellaneous diseases; Serum Amyloid P-Component - metabolism; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Lung disease; long pentraxin-3; Respiratory disease; Lung; Idiopathic pulmonary fibrosis; Idiopathic; Transplantation; Pentraxine PTX3; Homotransplantation; Respiratory system; Blood plasma; Pulmonary fibrosis; Treatment; Surgery; Graft; lung transplantation; Graft primary dysfunction; primary graft dysfunction
• ISSN: 1600-6135; 1600-6143; 1600-6143
• DOI: 10.1111/j.1600-6143.2011.03702.x

Primary graft dysfunction (PGD) after lung transplantation may result from ischemia reperfusion injury (IRI). The innate immune response to IRI may be mediated by Toll‐like receptor and IL‐1‐induced long pentraxin‐3 (PTX3) release. We hypothesized that elevated PTX3 levels were associated with PGD. We performed a nested case control study of lung transplant recipients with idiopathic pulmonary fibrosis (IPF) or chronic obstructive pulmonary disease (COPD) from the Lung Transplant Outcomes Group cohort. PTX3 levels were measured pretransplant, and 6 and 24 h postreperfusion. Cases were subjects with grade 3 PGD within 72 h of transplantation and controls were those without grade 3 PGD. Generalized estimating equations and multivariable logistic regression were used for analysis. We selected 40 PGD cases and 79 non‐PGD controls. Plasma PTX3 level was associated with PGD in IPF but not COPD recipients (p for interaction < 0.03). Among patients with IPF, PTX3 levels at 6 and 24 h were associated with PGD (OR = 1.6, p = 0.02 at 6 h; OR = 1.4, p = 0.008 at 24 h). Elevated PTX3 levels were associated with the development of PGD after lung transplantation in IPF patients. Future studies evaluating the role of innate immune activation in IPF and PGD are warranted. In a multicenter nested case control study of 119 lung transplant recipients, elevated plasma levels of the innate immune mediator long pentraxin‐3 are associated with the development of primary graft dysfunction in patients with idiopathic pulmonary fibrosis.