Dynamic of Angiotensin type I receptor antibodies is associated with poor graft function following lung transplant

Lung transplantation (LTx) saves the lives of patients with end-stage lung disease, but the longevity of transplanted lungs is much lower than that of other transplanted organs. Antibodies to angiotensin type 1 receptor (AT1Rabs) have been linked to poorer graft outcome. This single-centre observational study assessed 49 patients that underwent LTx between July 2014 and October 2015 at The Alfred. AT1Rabs levels were measured pre-LTx and one-year post-LTx. AT1Rabs levels ≤10 U/ml were considered negative, >10 U/ml and ≤17U/ml intermediate, and >17 U/ml positive. The mean age at LTx was 59±9 and 53% were male. The mean follow up time was 7±3 years. There was a significant decrease in AT1Rabs levels after LTx and implementation of immunosuppressive therapy (12.3 U/l vs 9.8 U/l, p<0.001). The change in AT1Rabs levels between negative, intermediate and positive can be defined as increasing, stable or decreasing (Figure1):6% of patients had an increase in AT1Rabs levels, whereas 61% were stable and 33% had a decrease. A risk category increase was associated with a lower FEV1% predicted value at 12 months compared to patients with stable or decreasing risk category (60%vs92%vs82%, p=0.039). Additionally, a risk category increase was associated with baseline lung allograft dysfunction (p=0.025). An increase in risk according to AT1Rabs levels is associated with poor graft function following LTX. <fig><object-id>erj;64/suppl_68/PA578/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>