1. Serum KL-6 level and the development of bronchiolitis obliterans syndrome in lung transplant recipients.
- Author
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Haberman B, Doan ML, Smith EO, Schecter MG, Mallory GB, and Elidemir O
- Subjects
- Adolescent, Adult, Biomarkers metabolism, Bronchiolitis Obliterans blood, Child, Female, Fibrosis pathology, Humans, Lung Diseases blood, Male, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome, Bronchiolitis Obliterans complications, Bronchiolitis Obliterans genetics, Lung Diseases therapy, Lung Transplantation methods, Mucin-1 blood
- 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., (© 2010 John Wiley & Sons A/S.)
- Published
- 2010
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