title: High levels of procalcitonin in the early phase after pediatric liver transplantation indicate poor postoperative outcome.
abstract: OBJECTIVE
  To date, no data is available about procalcitonin (PCT) levels and its relevance to morbidity and graft function in the early phase after pediatric liver transplantation (pLTx). The aim of this study was to analyse the prognostic relevance of early postoperative PCT elevations in pediatric liver recipients.
  
  
  METHODS
  Thirty pediatric patients who underwent 32 liver transplantations were included into this observational single-center study.
  
  
  RESULTS
  Patients with high PCT levels on postoperative day (POD) 2 had higher International Normalized Ratio values on POD 5 (p<0.05) and suffered more often from primary graft non-function (p<0.05). They also had a longer stay in the pediatric intensive care unit (p<0.01) and on mechanical ventilation (p=0.001). There was no correlation between PCT elevation and systemic infection. However, PCT levels were correlated with peak serum lactate levels immediately after graft reperfusion and elevation of serum aminotransferases on POD 1 (r2=0.61, p<0.001).
  
  
  CONCLUSIONS
  High levels of PCT after pLTx are an early indicator of poor postoperative outcome and may reflect ischemia induced liver cell injury within the context of an ischemia- reperfusion injury.
authors.forename: R
authors.initials: R
authors.lastname: Zant
authors.forename: M
authors.initials: M
authors.lastname: Melter
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: M
authors.initials: M
authors.lastname: Loss
authors.forename: M
authors.initials: M
authors.lastname: Ameres
authors.forename: B
authors.initials: B
authors.lastname: Knoppke
authors.lastname: Kunkel J
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D019934:International Normalized Ratio; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D055031:Primary Graft Dysfunction / Q000097:blood / Q000209:etiology; D011498:Protein Precursors / Q000097:blood*; D015427:Reperfusion Injury / Q000097:blood / Q000209:etiology; D012121:Respiration, Artificial; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D019344:Lactic Acid; D002116:Calcitonin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D015740:Calcitonin Gene-Related Peptide