title: The use and value of procalcitonin in solid organ transplantation.
abstract: Procalcitonin (PCT) has been increasingly used as a biomarker of bacterial infection and as a tool to guide antimicrobial therapy, especially in lower respiratory tract and bloodstream infections. Despite its increased use, data in patients with solid organ transplants are limited. Even without the presence of infection, PCT increases as a result of surgical procedures during transplantation, implantation of devices, and use of induction immunosuppressive therapy. The risk of infection is also higher in solid organ transplant recipients when compared to the general population. Monitoring PCT in the early post-transplant period seems to be a promising method for early detection of infectious complications. It has been shown that elevated PCT levels after one wk of transplantation are correlated with infectious complications. PCT may be a useful adjunctive biomarker that may improve early identification and guide appropriate treatment of infection or rejection, with the potential to further improve clinical outcomes. The use of serial PCT measurements may be more reliable than single values. It is important to recognize which factors may lead to PCT increases in the post-transplantation period, which in turn will help understand the kinetics and utility of this biomarker in this important patient population.
authors.affiliation: Division of Infectious Diseases, Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Uriel
authors.initials: U
authors.lastname: Sandkovsky
authors.affiliation: Division of Infectious Diseases, Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Andre C
authors.initials: AC
authors.lastname: Kalil
authors.affiliation: Division of Infectious Diseases, Transplant Infectious Diseases Program, University of Nebraska Medical Center, Omaha, NE, USA.|Transplant Surgery Division, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Diana F
authors.initials: DF
authors.lastname: Florescu
mesh_terms: D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D006801:Humans; D016377:Organ Transplantation; D011183:Postoperative Complications; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D013530:Surgical Wound Infection / Q000097:blood* / Q000175:diagnosis / Q000209:etiology
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: allograft rejection; heart transplant; immunosuppressive therapy; kidney transplant; liver transplant; procalcitonin; solid organ transplantation