Procalcitonin-a new diagnostic tool in complications following liver transplantation.
OBJECTIVE
Does procalcitonin (PCT) allow differentiation between infection and rejection following liver transplantation in the case of fever of unknown origin (FUO)?


METHODS
Open prospective trial.


METHODS
transplant intensive care unit at a university hospital.


METHODS
Forty patients after liver transplantation.


METHODS
Liver biopsy for diagnosis of rejection, transcutaneous aspiration cytology for monitoring of lymphocyte activation.


METHODS
Procalcitonin from EDTA plasma, APACHE II, Sepsis, score (Elbute and Stoner).


RESULTS
Eleven patients suffered an infectious complication resulting in an increase in PCT levels (2.2-41.7 ng/ml). Eleven patients developed a rejection episode; none of these patients showed a rise in PCT levels. The statistical difference between PCT levels in rejection and infection was significant (p<0.05) on the day of diagnosis.


CONCLUSIONS
PCT allows differentiation between rejection and infection in the case of FUO. Elevation of PCT plasma levels develops early postoperatively due to operation trauma, and, in the case of FUO with no rise in PCT, a rejection may be suspected.
Kuse
E R
ER
Medizinische Hochschule Hannover, Viszeral- und Transplantationschirurgie, D-30623 Hannover, Germany. Kuse.Ernst@MH-Hannover.DE
Langefeld
I
I
Jaeger
K
K
Külpmann
W R
WR
D018806:APACHE; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006084:Graft Rejection / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide