Pseudomonas aeruginosa and acute rejection independently increase the risk of donor-specific antibodies after lung transplantation.

Factors contributing to donor-specific HLA antibody (DSA) development after lung transplantation have not been systematically evaluated. We hypothesized that the isolation of Pseudomonas aeruginosa in respiratory specimens would increase the risk of DSA development. Our objective was to determine the risk of DSA development associated with the isolation of Pseudomonas aeruginosa after lung transplantation. We conducted a single-center retrospective cohort study of primary lung transplant recipients and examined risk factors for DSA development using Cox regression models. Of 460 recipients, 205 (45%) developed DSA; the majority developed Class II DSA (n = 175, 85%), and 145 of 205 (71%) developed DSA to HLA-DQ alleles. Univariate time-dependent analyses revealed that isolation of Pseudomonas from respiratory specimens, acute cellular rejection, and lymphocytic bronchiolitis are associated with an increased risk of DSA development. In multivariable analyses, Pseudomonas isolation, acute cellular rejection, and lymphocytic bronchiolitis remained independent risk factors for DSA development. Additionally, there was a direct association between the number of positive Pseudomonas cultures and the risk of DSA development. Our findings suggest that pro-inflammatory events including acute cellular rejection, lymphocytic bronchiolitis, and Pseudomonas isolation after transplantation are associated with an increased risk of DSA development.

In utero assessment of cardiovascular function in the embryonic mouse heart using high-resolution ultrasound biomicroscopy.

Murine models are currently the preferred approach for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene-targeting methods can be used to generate mice with altered cardiac size and function, and as a result, in vivo techniques are indispensible in evaluating cardiac phenotype. Traditionally, the pathologic assessment of sacrificed hearts was used to study cardiac pathophysiology in small animals. Below we describe the use of ultrasound biomicroscopy-Doppler analysis to temporally assess cardiac function in mouse embryos. Methods are described for obtaining 2D, pulsed-wave Doppler, and M-mode imaging using standard clinical cardiac ultrasound imaging planes.