OR17 Pre-transplant Panel Reactive Antibodies and HLA-A*/DQB1* Mismatches Associated with the Development of De Novo Donor Specific Antibody after Lung Transplant

Aim The incidence of HLA de novo donor specific antibody (dDSA) after lung transplant (LuTx) is prevalent and related to negative transplant outcomes. In the first large cohort study of its kind, we aim to assess pre-transplant predictors that are associated with development of dDSA afterLuTx. Methods We retrospectively recorded the development of dDSA among 422 recipients who underwent LuTx between 10/2012 and 12/2016 at our center. Recipient demographic characteristics including gender, age ( 65), race, blood type, histocompatibility factors of ⩾30% pre-transplant total panel reactive antibody (PRA), mean fluorescence intensity (MFI) of dDSA at the time of pre-transplant (0–500; >500  * , B * , C * , DRB1 * , DQB1 * , DPB1 * loci were analyzed for the development of dDSA. Results A total of 222 out of 422 (53%) recipients were identified with dDSA. Among 6 studied loci, HLA-A * and DQB1 * MMs were remarkably associated with the occurrence of dDSA (p  Conclusions MMs in HLA-A * and DQB1 * loci, as well as pre-transplant PRA ⩾30% are associated with dDSA production after LuTx and should be considered as the secondary pre-transplant histocompatibility risk factors that warrant closer post-transplant DSA monitoring.