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Serum KL‐6 level and the development of bronchiolitis obliterans syndrome in lung transplant recipients
Author(s) -
Haberman Brent,
Doan Minh L.,
Smith E. O’Brian,
Schecter Marc G.,
Mallory George B.,
Elidemir Okan
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2010.01373.x
Subject(s) - bronchiolitis obliterans , medicine , lung , gastroenterology , lung transplantation , respiratory disease , bronchiolitis , respiratory system , immunology
Haberman B, Doan ML, Smith EO, Schecter MG, Mallory GB, Elidemir O. Serum KL‐6 level and the development of bronchiolitis obliterans syndrome in lung transplant recipients.
Pediatr Transplantation 2010: 14:903–908. © 2010 John Wiley & Sons A/S. Abstract: KL‐6 is a glycoprotein expressed by pulmonary epithelial cells, and its serum level has been used as a marker of disease activity in a variety of respiratory illnesses. Previously, we showed that KL‐6 was elevated in lung transplant recipients diagnosed with BOS. In this study, we followed serum KL‐6 levels and lung functions prospectively in lung transplant recipients who were within the first five‐yr post‐transplant and had no evidence of BOS at the time of study entry. Mean peak KL‐6 levels were 596.16 ± 309.32 U/mL in the nine recipients who developed BOS compared to 352.41 ± 140.68 in 36 recipients who did not (p = 0.05). Six of the nine patients with BOS had an absolute rise in KL‐6 above baseline level >200 U/mL compared to two of the 37 who had the same increase in KL‐6 but did not develop BOS. Using the 200 U/mL elevation of KL‐6 from baseline as a threshold for a positive test would produce a sensitivity of 67%, specificity of 95%, PPV of 75%, and a NPV of 92%. In addition, mean KL‐6 levels of patients during acute rejection were not significantly elevated compared to the prerejection mean KL‐6 levels (p = 0.71). We conclude that serum KL‐6 is a relatively specific marker of BOS in lung transplant recipients.