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SPECIAL COMMUNICATION
Year : 2020  |  Volume : 5  |  Issue : 1  |  Page : 111-112

The role of serum kerbs von lungren 6 antigen in transfusion-related acute lung injury


Department of Critical Care Medicine; Department of Blood Transfusion, Luzhou People's Hospital, Luzhou, China

Date of Submission01-Apr-2020
Date of Decision01-Apr-2020
Date of Acceptance01-Apr-2020
Date of Web Publication17-Apr-2020

Correspondence Address:
Wang Gui-Qiang
Department of Critical Care Medicine; Department of Blood Transfusion, Luzhou People's Hospital, Luzhou
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GJTM.GJTM_26_20

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How to cite this article:
Gui-Qiang W, Xin-Mei L, Jun-Jian F, Li Z, Mao-Hua W. The role of serum kerbs von lungren 6 antigen in transfusion-related acute lung injury. Glob J Transfus Med 2020;5:111-2

How to cite this URL:
Gui-Qiang W, Xin-Mei L, Jun-Jian F, Li Z, Mao-Hua W. The role of serum kerbs von lungren 6 antigen in transfusion-related acute lung injury. Glob J Transfus Med [serial online] 2020 [cited 2020 Aug 11];5:111-2. Available from: http://www.gjtmonline.com/text.asp?2020/5/1/111/282733




  Introduction Top


Kerbs von Lungren 6 antigen (KL-6) is mainly secreted by proliferative, stimulated, or damaged alveolar epithelial type II cell. At present, KL-6 has been used as a serological indicator related to alveolar injury and severity in many respiratory diseases. Transfusion-related acute lung injury (TRALI) is a clinical syndrome characterized by acute noncardiogenic pulmonary edema and hypoxemia that occurs within 6 h after the transfusion. The pathogenesis of TRALI may involve the damage of alveolar epithelial cells and changes in alveolar capillary permeability. There are few reports on whether KL-6 can be used as a serological marker for the diagnosis of TRALI.


  Methods Top


In this study, we prospectively analyzed clinical, radiological, and laboratory data of a cohort of 95 patients supported by mechanical ventilation. All the data were collected before transfusion and at the time of 6 h after transfusion, including plasma BNP levels, arterial blood gas analysis, bedside chest X-ray examination, ventilator parameters, Murray lung injury score, and serum KL-6 levels. Ninety-five patients were categorized into TRALI group and non-TRALI group according to the criteria of TRALI. Serum KL-6 level was determined by enzyme-linked immunosorbent assay method. We compared the change of serum KL-6 levels between the TRALI group and non-TRALI group, analyzed the correlation between serum KL-6 and Murray lung injury score, and oxygenation index. We further evaluated the diagnostic value of serum KL-6 using ROC curve for diagnosing TRALI.
Figure 1: Correlation analysis between serum kl-6 level and Murray lung injury score

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  Results Top


All the indexes, including Murray lung injury score, plat pressure (Pplat), peak pressure (Ppeak), oxygenation index, serum KL-6 level, and BNP level, showed no significant differences between TRALI group and non-TRALI group before transfusion (P > 0.05). In TRALI group, we found much higher serum KL-6 level, Murray lung injury score, Ppeak, and Pplat and lower oxygenation at the time of 6 h after transfusion compared with baseline (P < 0.05). There was no significant difference in non-TRALI group. Compared with non-TRALI group, we found much higher serum KL-6 level, Murray lung injury score, Ppeak, and Pplat and lower oxygenation at the time of 6 h after transfusion (P < 0.05). Serum KL-6 level showed a positive correlation with lung injury score (correlation coefficient was 0.811, P < 0.001). Serum KL-6 level showed a negative correlation with the oxygenation index (correlation coefficient was 0.680, P < 0.001). ROC curve analysis showed that serum KL-6 level could be used for diagnosing TRALI, and the area under the curve was 0.966, P < 0.001. The sensitivity and specificity were 85.0% and 97.4%, respectively, when the level of serum KL-6 was higher than 369 U/ml.
Figure 2: Correlation analysis between serum KL-6 level and oxygenation index

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  Discussion and Conclusion Top


In our study, the results indicated when TRALI occurred in susceptible patients, damaged alveolar epithelial cells increased the expression of KL-6, and impairment of lung capillary permeability induced the increase of serum KL-6. In conclusion, serum KL-6 was a serological marker for acute lung injury, which might be helpful for TRALI diagnosis and severity evaluation of the patients with mechanical ventilation.

For detailed article log on to: Journal of Clinical Transfusion and Lab Medicine http://www.lcsxyjy.com/CN/10.3969/j.issn. 1671-2587.2019.05.001.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




    Figures

  [Figure 1], [Figure 2]



 

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