title: Early post-operative acute phase response in patients with early graft dysfunction is predictive of 6-month and 12-month mortality in liver transplant recipients.
abstract: Early allograft dysfunction (EAD) after liver transplantation is mostly a reversible event caused by factors related to ischemia/reperfusion (I/R) injury. EAD represents a hepatic injury associated with pre- and early post-transplant inflammatory cytokine responses. Aim of the present study was to evaluate the prognostic and diagnostic value of CRP in liver transplant recipients with EAD.
  
  
  METHODS
  Forty-seven patients with EAD were compared with 115 non-EAD patients. Pre- and post-transplant parameters were analyzed. EAD was defined based on postoperative liver function tests such as INR, bilirubin and liver enzymes. Statistical analysis was performed using SPSS version 18.0.
  
  
  RESULTS
  Pre-transplant liver enzyme were not significantly different in the two groups. At day 3, 5 and 10 post-transplant CRP was significantly higher in patients with EAD than in non-EAD patients (p⩽0.001 for all investigations) and remained consistently high in patients with EAD and low in non-EAD patients. EAD patients with high CRP at post-transplant days 3 and 5 showed lower survival at 6-month and 12-month post-transplant than patients with low CRP.
  
  
  CONCLUSIONS
  Our results indicate a prognostic and diagnostic value of CRP in patients with early graft dysfunction and predict 6-month and 12-month mortality in liver transplant recipients.
authors.affiliation: Department of Visceral Surgery, University of Heidelberg, Heidelberg, Germany; Zürich Surgical Center, Vascular and Visceral Surgery, Kappelistr. 7, CH-8002 Zürich, Switzerland. Electronic address: Hani.oweira@hirslanden.ch.
authors.forename: Hani
authors.initials: H
authors.lastname: Oweira
authors.affiliation: Transplantation Immunology, University of Heidelberg, Germany. Electronic address: imadlahdo@hotmail.com.
authors.forename: Imad
authors.initials: I
authors.lastname: Lahdou
authors.affiliation: 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: 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 Visceral Surgery, University of Heidelberg, Heidelberg, Germany; Zürich Surgical Center, Vascular and Visceral Surgery, Kappelistr. 7, CH-8002 Zürich, Switzerland. Electronic address: Jan.Schmidt@hirslanden.ch.
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: Department of Visceral Surgery, University of Heidelberg, Heidelberg, Germany; Department of HPB and Liver Transplantation Surgery, Rajhy Liver Hospital, Assiut University Hospital, Assuit, Egypt. Electronic address: ahmed.zidan@med.au.edu.eg.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Zidan
authors.affiliation: Department of Visceral Surgery, University of Heidelberg, Heidelberg, Germany. Electronic address: arianeb.mehrabil@med.uni-heidelberg.de.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: Department of Visceral 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: D000210:Acute-Phase Reaction / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D051799:Delayed Graft Function / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D002097:C-Reactive Protein; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin
keywords: CRP; Early graft dysfunction; Inflammatory responses; Transplantation