Procalcitonin as an early diagnostic marker for septic complications in the immediate postoperative setting after Living Donor Liver Transplantation (LDLT)
نویسندگان
چکیده
Background: Infection and rejection are the most common complications after liver transplantation. Both may develop during initial post-operative progress. Early differentiation is important for determination of the appropriate treatment. Objective: To investigate the ability of procalcitonin (PCT) in differentiation between infection and rejection in complicated cases in the immediate post-operative setting after LDLT. Method: The study includes 40 cases post liver transplantation. All adult patients underwent post-operative clinical course analysis, APACHE II and MELD score. Lab investigations included Procalcitonin, C-Reactive protein and TLC every 48 hours starting from day 6 post-operative. Results: Group 1: Patients without post-operative complication. Group 2: Patients with infection complication. Group 3: patients with early rejection pattern. Length of stay in ICU was longer in group 2 (16.40 ± 9.40, p value: 0.02). PCT and TLC levels were significantly high in group 2 in day 6 (5.27 ± 6.67, p value: 0.00) and (8.61 ± 6.94, p value 0.02) respectively. PCT, TLC and CRP ROC curves for prediction of infection show highest results with PCT (sensitivity 60 %, specificity 97 % and cut-off value 0.75 ng/ml, the area under the curve is 0.883). In group 2, PCT levels showed significant percentage changes between day 8 to day 10 (15.86 ± 73.40, p value 0.018), day 10 to day 12 (15.96 ± 56.69 p value: 0.018) and day 12 to day 14 (15.09 ± 71.74 p value 0.043). In group 2, there was strong direct correlation between the percentage changes of PCT, TLC in day 6 to day 8 (p value: 0.00, R + 0.998). Conclusion: Based on these results, we recommend that PCT possesses important diagnostic and prognostic power in the post-transplant sepsis after liver transplantation.
منابع مشابه
The Role of Procalcitonin in the Early Diagnosis of Septic and Non-Septic Complications in the Immediate Postoperative Setting After Orthotopic Liver Transplantation
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