title: Early post-transplant neopterin associated with one year survival and bacteremia in liver transplant recipients.
abstract: Bacterial infections are the most common complications, and the major cause of mortality after liver transplantation (Tx). Neopterin, a marker of immune activation, is produced in monocyte/macrophages in response to inflammation. The aim of our study was to investigate whether early post-operation serum levels of neopterin were associated with post-transplant bacteremia and mortality in liver transplant recipients. We studied 162 of 262 liver Tx patients between January 2008 and February 2011 of whom pre- and early post-Tx sera samples were available. Pre- and early post-operative risk factors of infection and mortality were evaluated in 45 bacteremic patients and 117 non-bacteremic patients. During one-year follow-up, 28 of 262 patients died because of graft failure, septicemia and other diseases. Post-Tx serum neopterin on day 10 (p<0.001) were significantly higher in bacteriemic patients than in patients without bacteremia. Logistic regression analyses showed that day 10 post-Tx neopterin serum level ⩾40 nmol/l has a predictive value (OR=6.86: p<0.001) for bacteremia and mortality (OR=3.47: p=0.021). Our results suggest that early post-Tx neopterin serum levels are very sensitive predictive markers of one-year post-Tx bacteremia and mortality in liver Tx recipients.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; Vascular and Visceral Surgery Center, Kappelistrasse 7, 8002 Zürich, Switzerland. Electronic address: Hani.Oweira@hirslanden.ch.
authors.forename: Hani
authors.initials: H
authors.lastname: Oweira
authors.affiliation: Department Transplantation Immunology, University of Heidelberg, Germany. Electronic address: imadlahdo@hotmail.com.
authors.forename: Imad
authors.initials: I
authors.lastname: Lahdou
authors.affiliation: Department Transplantation Immunology, University of Heidelberg, Germany. Electronic address: volker.daniel@med.uni-heidelberg.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Daniel
authors.affiliation: Department of Anesthesiology, University of Heidelberg, Germany. Electronic address: stefan.hofer@med.uni-heidelberg.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: markus.mieth@med.uni-heidelberg.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Mieth
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany; Vascular and Visceral Surgery Center, Kappelistrasse 7, 8002 Zürich, Switzerland. Electronic address: Jan.Schmidt@hirslanden.ch.
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: peter.schemmer@med.uni-heidelberg.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Schemmer
authors.affiliation: Department Transplantation Immunology, University of Heidelberg, Germany. Electronic address: gerhard.opelz@med.uni-heidelberg.de.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Opelz
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: arianeb.mehrabi@med.uni-heidelberg.de.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: mahmoud.sadeghi@med.uni-heidelberg.de.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Sadeghi
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000175:diagnosis* / Q000401:mortality; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000401:mortality; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D019798:Neopterin
keywords: Liver; Neopterin; Outcome; Transplantation