title: Is procalcitonin useful to differentiate rejection from bacterial infection in the early post-operative period of liver transplantation in children?
abstract: PCT is a protein that is recognized as an acute marker of inflammation. Previous studies performed in adults who underwent liver or heart transplantation indicated that PCT plasmatic levels help to differentiate between rejection and infection. The objective of this study was to evaluate whether PCT has the same role in liver-transplanted children. Thirty-six patients were studied between the first and the thirtieth post-operative days, and PCT determinations were prospectively performed according to the clinical status of the patient. In the non-complicated patients, PCT measurements performed on the first and second post-operative days revealed a median value of 1.60 ng/mL (mean 5.68 +/- 7.05; range 0.69-18.30). After the fourth day of transplantation, PCT plasma concentrations decreased to a median value of 0.21 ng/mL (mean 0.47 +/- 0.59; range 0.05-2.00; normal values are less than 0.5 ng/mL). In infected patients, PCT plasma levels demonstrated a significant increase, differing from the patients with acute liver rejection whose levels were similar to those of non-complicated patients. In conclusion, we could demonstrate that in the early post-operative period of liver transplantation in children, measuring PCT plasmatic levels might be a useful tool for differentiation between bacterial infection and acute liver rejection.
authors.affiliation: Pediatric Surgery Division, Pediatric Liver Transplantation Unit and Pediatric Surgery Laboratory (LIM 30), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Maria Cecília Mendonça
authors.initials: MC
authors.lastname: Coelho
authors.forename: Uenis
authors.initials: U
authors.lastname: Tannuri
authors.forename: Ana Cristina Aoun
authors.initials: AC
authors.lastname: Tannuri
authors.forename: Claudio
authors.initials: C
authors.lastname: Reingenheim
authors.forename: Eduardo Juan
authors.initials: EJ
authors.lastname: Troster
mesh_terms: D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide