E R Kuse1, I Langefeld, K Jaeger, W R Külpmann. 1. Department of Abdominal and Transplantation Surgery, Medizinische Hochschule Hannover, Germany. Kuse.Ernst@MH-Hannover.DE
Abstract
OBJECTIVE: Does procalcitonin (PCT) differentiate between infection and rejection after liver transplantation in patients with fever of unknown origin? DESIGN: Open prospective trial. SETTING: Transplant intensive care unit at a university hospital. PATIENTS: Forty patients after liver transplantation. INTERVENTIONS: Liver biopsy for the diagnosis of rejection and transcutaneous aspiration cytology for monitoring of lymphocyte activation. MEASUREMENTS: Procalcitonin from EDTA plasma, Acute Physiology and Chronic Health Evaluation II, and sepsis score. RESULTS: Eleven patients experienced an infectious complication resulting in an increase in PCT concentrations (2.2-41.7 ng/mL). Eleven patients had a rejection episode; none of these patients showed a rise in PCT concentrations. The statistical difference between PCT concentrations in rejection and infection was significant (p<.05) on the day of diagnosis. CONCLUSION: PCT allows for differentiation between rejection and infection in patients with fever of unknown origin. Elevation of PCT plasma concentrations develops early postoperatively from operation trauma, and in the case of fever of unknown origin, with no rise in PCT, a rejection may be suspected.
OBJECTIVE: Does procalcitonin (PCT) differentiate between infection and rejection after liver transplantation in patients with fever of unknown origin? DESIGN: Open prospective trial. SETTING: Transplant intensive care unit at a university hospital. PATIENTS: Forty patients after liver transplantation. INTERVENTIONS: Liver biopsy for the diagnosis of rejection and transcutaneous aspiration cytology for monitoring of lymphocyte activation. MEASUREMENTS: Procalcitonin from EDTA plasma, Acute Physiology and Chronic Health Evaluation II, and sepsis score. RESULTS: Eleven patients experienced an infectious complication resulting in an increase in PCT concentrations (2.2-41.7 ng/mL). Eleven patients had a rejection episode; none of these patients showed a rise in PCT concentrations. The statistical difference between PCT concentrations in rejection and infection was significant (p<.05) on the day of diagnosis. CONCLUSION: PCT allows for differentiation between rejection and infection in patients with fever of unknown origin. Elevation of PCT plasma concentrations develops early postoperatively from operation trauma, and in the case of fever of unknown origin, with no rise in PCT, a rejection may be suspected.
Authors: K Stankovic Stojanovic; O Steichen; F Lionnet; C Bachmeyer; I Lecomte; V Avellino; G Grateau; R Girot; G Lefevre Journal: Infection Date: 2011-01-11 Impact factor: 3.553
Authors: Wan Soo Lee; Dae Woong Kang; Jong Hun Back; Hyun Lee Kim; Jong Hoon Chung; Byung Chul Shin Journal: Korean J Intern Med Date: 2015-02-27 Impact factor: 2.884
Authors: Daniel Eyraud; Saïd Ben Ayed; Marie Laure Tanguy; Corinne Vézinet; Jean Michel Siksik; Maguy Bernard; Sylvia Fratéa; Marie Movschin; Jean-Christophe Vaillant; Pierre Coriat; Laurent Hannoun Journal: Crit Care Date: 2008-07-04 Impact factor: 9.097
Authors: Gian Paolo Castelli; Claudio Pognani; Michael Meisner; Antonio Stuani; Daniela Bellomi; Laura Sgarbi Journal: Crit Care Date: 2004-06-10 Impact factor: 9.097