Relationship between procalcitonin values and infection in brain-dead organ donors.
OBJECTIVE
An association between the inflammatory reactions estimated by several biomarkers and organ dysfunction has been reported in brain-dead organ donors (BDOD). Procalcitonin (PCT), a biomarker of inflammation due to bacterial infection, is increased among BDOD. However, is not known whether infection changes PCT values in BDOD.


METHODS
We retrospectively analyzed 82 BDOD including several demographic and clinical parameters, bacterial culture results, antibiotics prescription, and plasma values of PCT measured before organ harvesting. Infection was diagnosed to be either a positive bacterial culture (restricted definition) and/or prescription of antibiotics (extended definition).


RESULTS
The median PCT value was 1.5 (interquartile range [IQR], 0.4 to 6.9; range, 0 to 526 ng/mL; n=82). Thirty-eight (46%) and 24 (29%) patients had PCT values>2 ng/mL and >5 ng/mL, respectively. Median PCT values among infected (1.18; IQR, 0.27 to 6.55 ng/mL) versus noninfected (1.57; IQR, 0.53 to 7.15 ng/mL) BDOD (restricted definition) were not different (P=.36). The area under the receiver operating characteristic curve using PCT to predict infection (restricted definition) was 0.52. Specificity of PCT to predict infection was above 80% at PCT values>9 ng/mL.


CONCLUSIONS
Our results confirmed PCT values are increased in BDOD, suggesting that this was not related to an infectious cause (whatever definition was used) unless PCT values are high.
Rangeard
O
O
Pôle d'Anesthésie-Réanimation, Centre Hospitalier Universitaire de Nancy, Nancy, France.
Audibert
G
G
Perrier
J-F
JF
Loos-Ayav
C
C
Lalot
J-M
JM
Agavriloaie
M
M
Meistelman
C
C
Grégoire
H
H
Mertes
P M
PM
Longrois
D
D
D001926:Brain Death; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002423:Cause of Death; D006084:Graft Rejection / Q000453:epidemiology* / Q000401:mortality; D020197:Head Injuries, Penetrating; D006801:Humans; D011498:Protein Precursors / Q000097:blood*; D014019:Tissue Donors / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide