Procalcitonin in the Setting of Complicated Postoperative Course after Liver Transplantation

Abstract Background Orthotopic liver transplantation (OLT) is a treatment for end-stage liver disease. The shortage of available organs leads to the acceptance of marginal grafts, thereby increasing the risk of perioperative complications such as acute rejection, infection, and graft dysfunction Pro...

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Bibliographic Details
Published in:Transplantation proceedings 2010-12, Vol.42 (10), p.4187-4190
Main Authors: Perrakis, A, Yedibela, S, Schellerer, V, Hohenberger, W, Müller, V
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biomarkers - blood
Calcitonin - blood
Calcitonin Gene-Related Peptide
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Humans
Liver Diseases - surgery
Liver Transplantation
Liver, biliary tract, pancreas, portal circulation, spleen
Medical sciences
Postoperative Period
Prognosis
Protein Precursors - blood
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Tissue, organ and graft immunology
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Summary:Abstract Background Orthotopic liver transplantation (OLT) is a treatment for end-stage liver disease. The shortage of available organs leads to the acceptance of marginal grafts, thereby increasing the risk of perioperative complications such as acute rejection, infection, and graft dysfunction Procalcitonin (PCT) has been shown to be a reliable marker for a complicated course after traumamatic injury as well as in the courses of systemic inflammatory response syndrome and sepsis. The aim of our study was to evaluate PCT as an early prognostic marker for the occurrence of complication during the postoperative course after OLT. Method We analyzed PCT levels and clinical and paraclinical data of 32 patients who underwent 33 OLTs. The highest PCT was termed as peak-PCT. Patients were stratified into noncomplication and complication groups. Renal replacement therapy, respiratory insufficiency, postoperative bleeding, refractory ascites, pleural effusion, rejection, sepsis, and fatal outcome were defined as complications. A secondary stratification, using a peak-PCT of 5 ng/mL, was used to analyzed the risk of a complication. We also analyzed the course of PCT after OLT in each group. Results The peak-PCT, which occurred between the first and third postoperative day in 30 patients, was followed by halving of the value every second day. Three subjects died because of sepsis. A constantly rising PCT or a secondary rise observed in 2 patients was associated with a fatal outcome. The noncomplication group included 18 patients, 8 of them showing a peakPCT
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2010.08.070