Elevated plasma Clara cell secretory protein concentration is associated with high-grade primary graft dysfunction

Joshua M. Diamond, S. M. Kawut, D. J. Lederer, V. N. Ahya, B. Kohl, J. Sonett, S. M. Palmer, M. Crespo, K. Wille, V. N. Lama, P. D. Shah, J. Orens, S. Bhorade, A. Weinacker, E. Demissie, S. Bellamy, J. D. Christie, L. B. Ware

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Primary graft dysfunction (PGD) is the leading cause of early posttransplantmorbidity andmortality after lung transplantation. Clara cell secretory protein (CC16) is produced by the nonciliated lung epithelium and may serve as a plasma marker of epithelial cell injury. We hypothesized that elevated levels of CC16 would be associated with increased odds of PGD. We performed a prospective cohort study of 104 lung transplant recipients. Median plasma CC16 levels were determined at three time points: pretransplant and 6 and 24 h posttransplant. The primary outcome was the development of grade 3 PGD within the first 72 h after transplantation. Multivariable logistic regression was performed to evaluate for confounding by donor and recipient demographics and surgical characteristics. Twenty-nine patients (28%) developed grade 3 PGD within the first 72 h. The median CC16 level 6 h after transplant was significantly higher in patients with PGD [13.8 ng/mL (IQR 7.9, 30.4 ng/mL)] than in patients without PGD [8.2 ng/mL (IQR 4.5, 19.1 ng/mL)], p = 0.02. Elevated CC16 levels were associated with increased odds of PGD after lung transplantation. Damage to airway epithelium or altered alveolar permeability as a result of lung ischemia and reperfusion may explain this association.

Original languageEnglish (US)
Pages (from-to)561-567
Number of pages7
JournalAmerican Journal of Transplantation
Issue number3
StatePublished - Mar 2011


  • Clara cell
  • Lung transplantation
  • Primary graft dysfunction

ASJC Scopus subject areas

  • Transplantation
  • Pharmacology (medical)
  • Immunology and Allergy


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