CASE REPORT article

Front. Transplant.

Sec. Thoracic Transplantation

Lung Transplant Recipient with Bullous Pemphigoid and Antibody-Mediated Rejection: An Overlapping Immunologic Phenomenon?

    SH

    Sandrine Hanna 1

    DG

    Daniel Gutteridge 1

    CM

    Christiane Machado 2

    MG

    Mrunal G Patel 1

    DW

    David W Roe 1

    NS

    Nichole Smith 1

    BS

    Biplab Saha 1

  • 1. Pulmonary, Critical Care & Lung Transplant, Indiana University Health University Hospital, Indianapolis, United States

  • 2. Dermatology, Indiana University Health University Hospital, Indianapolis, United States

The final, formatted version of the article will be published soon.

Abstract

We present what is, to our knowledge, the first reported case of concurrent bullous pemphigoid (BP) and antibody-mediated rejection (AMR) in a lung transplant patient. Similar associations have been described in other solid organ transplant settings, most notably in renal transplantation, where explantation of the allograft has frequently been followed by resolution of the skin disease. These observations suggest a broader potential connection between autoimmune blistering disorders and allograft rejection mechanisms, especially as emerging evidence highlights the role of non–HLA antibodies. A comprehensive review of previously reported cases of BP in solid organ transplant recipients is therefore warranted to place this case in context and to assess its significance within the existing literature.

Summary

Keywords

Antibody mediated rejection, Blistering skin disease, Bullous pemphigod, Donor specific antibodies, lung transplatation

Received

23 December 2025

Accepted

20 February 2026

Copyright

© 2026 Hanna, Gutteridge, Machado, Patel, Roe, Smith and Saha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Sandrine Hanna

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