Multi-site cytokine levels are predictive of primary graft dysfunction following lung transplantation

Le résumé fourni par la source

There is an urgent need to better understand the pathophysiology of primary graft dysfunction (PGD) to develop point-of-care methods predicting those at risk. We utilized a multiplex multivariable approach to define cytokines, chemokines, and growth factors in patient-matched biospecimens to identify factors predictive of PGD. Biospecimens were collected from patients undergoing bilateral lung transplantation (LTx) from three sites: donor lung perfusate, post-transplant bronchoalveolar lavage (BAL) fluid (2h), and plasma (2h, 24h, 72h, and 1 and 2 wks). A 71-multiplex panel was performed on each. Cross-validated logistic regression (LR) and random forest (RF) models determined whether analytes from each site, alone or combined with clinical data, discriminated PGD grade 0 (n = 9) vs. 3 (n = 8). BAL fluid at 2h was most predictive of PGD (LR, 0.825; RF, 0.919), followed by multi-timepoint plasma (LR, 0.841; RF, 0.653), then perfusate (LR, 0.565; RF, 0.448). Combined clinical, BAL, and plasma data yielded the strongest performance (LR, 1.000; RF, 1.000). BAL collected 2h post-transplant showed the strongest discriminatory signal for severe PGD in this exploratory cohort. This integrative approach identified IL-1RA, BCA-1, and Fractalkine as hypothesis-generating candidate biomarkers that warrant validation in larger independent studies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.