Die prädiktive und prognostische Rolle von Procalcitonin im postoperativen Verlauf nach Lebertransplantation
Aims: To assess the diagnostic accuracy of procalcitonin (PCT) as marker for infectious and non infectious complications and as prognostic factor in the posttransplant setting.
Material and methods: All liver transplant patients between January 2007 and April 2011 were prospectively included in the study. Postoperative clinical course was prospectively analyzed from admission to discharge. Main proceeding data such as operating procedure, type of reperfusion, operating and ischemic times, HU status and MELD score at time of transplantation were also recorded and evaluated.
Results: The median survival time (range) was 16 months (8 – 51 months). Sixteen patients with initial PCT > 5 ng/mL suffered ≥1 complications (p = 0.03). There was no relevance between the 1st peak-PCT and the further postoperative course or the occurrence of complications (p = 0.442). Patients, in which a 2nd PCT peak was occurred, had a significantly higher risk for a complicated course (p = 0.01), for a complicated sepsis course (p < 0.0001) and for mortality (p < 0.0001). Warm ischemic time over 58 minutes, operating time over 389 minutes and HU status were significant independent factors for a complicated postoperative course and the occurrence of a 2nd PCT peak (p < 0.001, p < 0.001 and p = 0.03 respectively).
Conclusion: Based on our results we believe that PCT and the occurrence of a 2nd peak seem to possess important diagnostic and prognostic power in the posttransplant setting.