title: Plasma proteome to look for diagnostic biomarkers of early bacterial sepsis after liver transplantation: a preliminary study.
abstract: BACKGROUND
  While outcome continuously improves after liver transplantation, sepsis remains the leading cause of early postoperative mortality. Diagnosis of infections remains particularly difficult in these patients. This study used plasma profiling coupling Proteinchip array with surface-enhanced laser desorption ionization time-of-fly mass spectrometry to search for biomarkers of postoperative sepsis in patients who underwent liver transplantation.
  
  
  METHODS
  Diagnosis of sepsis at day 5 relied on widely accepted clinical signs and positive culture of microbiologic samples. Profiles of day 5 plasma were obtained from SELDI-TOF CM10 chip (BioRad, Marnes-la-Coquette, France) analysis. Mean peak intensity of proteins was compared between septic and nonseptic plasma by U test followed by analysis of the area under the receiver-operating characteristic for the significant peaks. Diagnostic performance of significant proteins was established in a derivation set and in a validation set.
  
  
  RESULTS
  In the derivation set of 31 patients with and 30 without infection, 23 plasma protein peaks were differentially expressed between patients with and without sepsis. Combination of five peaks allowed sepsis diagnosis with a positive likelihood ratio of 12.5 and a C-statistics of 0.72, 95% CI 0.57-0.85. In the validation set of 31 patients with infection and 34 without infection, the five peaks were differentially expressed as well and allowed day 5 sepsis diagnosis with a positive likelihood ratio of 5.1 and C-statistics of 0.74 (0.58-0.85).
  
  
  CONCLUSIONS
  A combination of five plasma protein peaks may provide material for useful diagnostic biomarkers of postoperative sepsis in patients undergoing liver transplantation. However, these proteins remain to be identified.
authors.affiliation: Department of Anesthesiology and Critical Care, University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, Bd du Général Leclerc, Clichy, France. catherine.paugam@bjn.aphp.fr
authors.forename: Catherine
authors.initials: C
authors.lastname: Paugam-Burtz
authors.forename: Miguel
authors.initials: M
authors.lastname: Albuquerque
authors.forename: Gabriel
authors.initials: G
authors.lastname: Baron
authors.forename: Frederic
authors.initials: F
authors.lastname: Bert
authors.forename: Hélène
authors.initials: H
authors.lastname: Voitot
authors.forename: Didier
authors.initials: D
authors.lastname: Delefosse
authors.forename: Federica
authors.initials: F
authors.lastname: Dondero
authors.forename: Daniele
authors.initials: D
authors.lastname: Sommacale
authors.forename: Claire
authors.initials: C
authors.lastname: Francoz
authors.forename: Nadine
authors.initials: N
authors.lastname: Hanna
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Philippe
authors.initials: P
authors.lastname: Ravaud
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.forename: Jean
authors.initials: J
authors.lastname: Mantz
authors.forename: Valérie
authors.initials: V
authors.lastname: Paradis
mesh_terms: D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000032:analysis*; D001772:Blood Cell Count; D001798:Blood Proteins / Q000235:genetics*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology / Q000382:microbiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D011498:Protein Precursors / Q000097:blood; D020543:Proteome / Q000378:metabolism*; D015203:Reproducibility of Results; D018805:Sepsis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D012772:Shock, Septic / Q000209:etiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D011498:Protein Precursors; D020543:Proteome; D002116:Calcitonin; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases