Open AccessUse of serum KL-6 level for detecting patients with restrictive allograft syndrome after lung transplantation
Author(s) -
Cristina Berastegui,
Susana Gómez-Ollés,
Alberto Mendoza-Valderrey,
Thais Pereira-Veiga,
Mario Culebras,
Vı́ctor Monforte,
Berta Sáez,
Manuel López Meseguer,
Helena Sintes-Permanyer,
Victoria Ruiz de Miguel,
Carlos Bravo,
Judith Sacanell,
María Antonia Ramon,
Laura Romero,
María Teresa Armenta Deu,
Antonio Román
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0226488
Subject(s) - bronchiolitis obliterans , bronchoalveolar lavage , medicine , lung transplantation , biomarker , gastroenterology , lung , bronchiolitis , immunology , transplantation , cohort , pathology , respiratory system , biology , biochemistry
KL-6 is an antigen produced mainly by damaged type II pneumocytes that is involved in interstitial lung disease. Chronic lung allograft dysfunction (CLAD) after lung transplantation (LT) is a major concern for LT clinicians, especially in patients with restrictive allograft syndrome (RAS). We investigated KL-6 levels in serum and bronchoalveolar lavage fluid (BALF) as a potential biomarker of the RAS phenotype. Levels of KL-6 in serum and BALF were measured in 73 bilateral LT recipients, and patients were categorized into 4 groups: stable (ST), infection (LTI), bronchiolitis obliterans syndrome (BOS), and RAS. We also studied a healthy cohort to determine reference values for serum KL-6. The highest levels of KL-6 were found in the serum of patients with RAS (918 [487.8–1638] U/mL). No differences were found for levels of KL-6 in BALF. Using a cut-off value of 465 U/mL serum KL-6 levels was able to differentiate RAS patients from BOS patients with a sensitivity of 100% and a specificity of 75%. Furthermore, higher serum KL-6 levels were associated with a decline in Forced Vital Capacity (FVC) at 6 months after sample collection. Therefore, KL-6 in serum may well be a potential biomarker for differentiating between the BOS and RAS phenotypes of CLAD in LT recipients.