Mathematical modeling of peripheral blood neutrophil kinetics to predict CLAD after lung transplantation

Adult Graft Rejection Male Neutrophils 03 medical and health sciences 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases 616 Humans [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology Retrospective Studies [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases Mathematical Modeling Graft Survival Computational Biology 600 Middle Aged Models, Theoretical Allografts Prognosis [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system 3. Good health Blood Lung transplantation Graft rejection [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology Chronic Disease [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases Female [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology [SDV.MP.PAR] Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology Lung Transplantation
DOI: 10.1016/j.trim.2020.101321 Publication Date: 2020-07-23T01:17:11Z
ABSTRACT
The presence of neutrophils in the lung was identified as a factor associated with CLAD but requires invasive samples. The aim of this study was to assess the kinetics of peripheral blood neutrophils after lung transplantation as early predictor of CLAD.We retrospectively included all recipients transplanted in our center between 2009 and 2014. Kinetics of blood neutrophils were evaluated to predict early CLAD by mathematical modeling using unadjusted and adjusted analyses.103 patients were included, 80 in the stable group and 23 in the CLAD group. Bacterial infections at 1 year were associated with CLAD occurrence. Neutrophils demonstrated a high increase postoperatively and then a progressive decrease until normal range. Recipients with CLAD had higher neutrophil counts (mixed effect coefficient beta over 3 years = +1.36 G/L, 95% Confidence Interval [0.99-1.92], p < .001). A coefficient of celerity (S for speed) was calculated to model the kinetics of return to the norm before CLAD occurrence. After adjustment, lower values of S (slower decrease of neutrophils) were associated with CLAD (Odds Ratio = 0.26, 95% Confidence Interval [0.08-0.66], p = .01).A slower return to the normal range of blood neutrophils was early associated with CLAD occurrence.
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