Abstract
Chronic allograft dysfunction (CLAD) is the main limitation for Lung Transplantation (LT) survival. There is known 2 forms of CLAD: obliterative bronchiolitis syndrome (BOS) and restrictive allograft syndrome (RAS). The detection of the glycoprotein KL-6 in bronchoalveolar lavage (BAL) or serum in LT population may discriminate between both. The objective of the study was to analyse KL-6 levels in BAL and in serum from LT population in differents situations : stable (ST) , infection (LTI), BOS and RAS.
Patients and methods - Forty four patients with bilateral LT and who survived more than 3 months were included. The population were divided in 4 groups : 14 ST patients, 10 LTI patients, 12 BOS patients and 8 patients with RAS. BAL and serum samples from the 44 patients were analysed with the Kit KL-6 ( Eidia Co.,Ltd.,Tokyo, Japan). U Mann Whitney were used to analysed differences between groups
Results - KL-6 levels in serum were higher in RAS patients at a median of 1042 [IQR 504,9 to 1592]. Significant differences were shown between RAS vs ST, LTI and BOS patients with p-value of 0,0001, 0,0031 and 0,0055 respectively. KL-6 levels in BAL were higher in ST patients at a median of 262,3 [ IQR 117,9 to 661,8 ]. Significant differences were only shown between ST vs LTI patients (p=0,0088) and LTI vs BOS patients ( p=0,0168).
Conclusion - KL-6 measured in serum from LT population with RAS are the highest values compared with the rest. KL-6 in serum seems to be better biomarker for RAS than in BAL.
- Copyright ©the authors 2016