Sirolimus-Induced Severe Hypertriglyceridemia in a Lung Transplant Recipient

dures for acute rejection episodes and coronary angiography or intravascular ultrasound for graft vasculopathy are used to assess the status of the allograft. Molecular and genetic markers may represent new ways to monitor the graft, which could minimize the potential complications of such invasive techniques. Our findings illustrate that sHLA-G expression seems protective against clinically significant acute cellular rejection. For the first time, we also show a negative association between sHLA-G levels and C4d staining, suggesting inhibition of the humoral response. Evidence indicates that myocardial HLA-G expression postheart transplant protects against coronary artery disease (2). We have also previously demonstrated that myocardial HLA-G expression reliably indicates a low risk of acute cellular rejection in patients from our center (3). This study suggests that sHLA-G expression is negatively linked to C4d staining in addition to acute cellular rejection. Because both forms of rejection contribute to graft vascular disease, sHLA-G expression could aid in identifying the immunologic risk of heart transplant recipients. Hence, further investigation between HLA-G expression and humoral rejection may be warranted through larger studies.