Clinical usefulness of serum C-reactive protein in living donor liver transplantation.
OBJECTIVE
The typical inflammatory response is frequently absent and the clinical manifestations of complications are often vague in LDLT recipients. So the rapid, sensitive, simple and noninvasive laboratory test may be very useful in postoperative care for LDLT recipients.


METHODS
Excluding 5 pediatric LDLTs and 8 CDLTs, in total 100 adult LDLTs from January 2004 to June 2004 were retrospectively analyzed.


RESULTS
Seventy-three episodes (24.9%) of CRP elevation were related with infection and 22 episodes (7.51%) were related with acute rejection. Sensitivity and specificity of serum CRP in infection and ACR were 0.90 and 0.65, respectively. The serum CRP level showed significant rise in infectious complications. The median peak value was 12.6 mg/dL and the range was 0.5-40.7 mg/dL. And recipients accompanying septic feature showed higher level of peak CRP. The recipients with acute rejection also showed elevated CRP but modest elevation (1.5-8.7 mg/dL). There was no correlation between the severity of rejection and serum CRP level. And the serum CRP rises were more frequently observed than leukocytosis and fever in recipients with infection or rejection.


CONCLUSIONS
Serum CRP is quite sensitive but non-specific marker for diagnosis of infection and ACR. Serum CRP was a more sensitive marker for infection and ACR than fever or leukocytosis.
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gi-Won
GW
Song
Sung-Gyu
SG
Lee
Kwang-Min
KM
Park
Shin
S
Hwang
Ki-Hun
KH
Kim
Chul-Soo
CS
Ahn
Deok-Bog
DB
Moon
Tae-Yong
TY
Ha
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis*; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D007964:Leukocytosis / Q000453:epidemiology; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood; D012772:Shock, Septic / Q000097:blood
D002097:C-Reactive Protein