Cellular Biomarkers of Rejection in Lung Transplant: The Usefulness of Eosinophil and Lymphocyte Counts

Abstract

There is increasing interest in the development of biomarkers of acute cellular rejection (ACR) and chronic allograft dysfunction (CLAD) in lung transplant recipients. However, few studies have focused on the predictive value of cellular biomarkers usually available in routine clinical practice such as eosinophils (EOS) and lymphocytes. Peripheral blood eosinophilia has been associated with ACR in kidney, heart and liver transplant recipients. There are few studies in relation to EOS counts in lung transplants. In our experience, the increase in EOS in peripheral blood may be a warning sign of rejection that advises to expand the assessment with a bronchoscopy (FBS), transbronchial biopsy (TBB) and bronchoalveolar lavage (BAL). Lymphocytes are essential cells in the development of ACR. The increase in lymphocytes in the BAL fluid (BALF) may be indicative of ACR, especially if it is associated with a simultaneous increase in the EOS count in the peripheral blood.

Keywords

• Acute rejection. Bronchoalveolar lavage (BAL). Eosinophils. Lymphocytes. Peripheral blood.