title: Procalcitonin for infections in the first week after pediatric liver transplantation.
abstract: Procalcitonin (PCT) has become a commonly used serum inflammatory marker. Our aim was to describe the kinetics and usefulness of serial post-operative PCT measurements to detect bacterial infection in a cohort of children immediately after pediatric liver transplantation (pLT).
  
  
  
  We performed a retrospective chart review of a cohort of pLT recipients with serial serum PCT measurements in the first week following pLT. The presence of infection was determined on clinical and biological parameters. Normal PCT was defined as < 0.5 (ng/ml).
  
  
  
  Thirty-nine patients underwent 41 pLT. PCT was measured daily during the first week post pLT. Values first increased following surgery and then decreased, nearing 0.5 ng/ml at day seven. Peak PCT reached a median of 5.61 ng/ml (IQR 3.83-10.8). Seventeen patients were considered to have an infection. There was no significant difference in daily PCT or peak PCT between infected and non infected patients during the first post-operative week. AUC of ROC curve for PCT during first week was never higher than 0.6.
  
  
  
  We conclude that serial PCT measurements during the first week after pLT is not useful to identify patients with bacterial infections. Rather, we propose that serum PCT may be useful after the first week post pLT.
authors.affiliation: Pediatric Gastroenterology Unit, University Hospitals Geneva, Rue Willy-Donzé 6, 1211, Geneva, Switzerland. vladimir.cousin@hcuge.ch.
authors.forename: Vladimir L
authors.initials: VL
authors.lastname: Cousin
authors.affiliation: Faculty of Medicine, Geneva, Switzerland.
authors.forename: Kalinka
authors.initials: K
authors.lastname: Lambert
authors.affiliation: Faculty of Medicine, Geneva, Switzerland.
authors.forename: Shahar
authors.initials: S
authors.lastname: Trabelsi
authors.affiliation: Pediatric Emergency Division, University Hospitals Geneva, Geneva, Switzerland.
authors.forename: Annick
authors.initials: A
authors.lastname: Galetto-Lacour
authors.affiliation: Pediatric Infectious Disease Unit, Department of Pediatrics, University Hospitals Geneva & University of Geneva, Geneva, Switzerland.
authors.forename: Klara M
authors.initials: KM
authors.lastname: Posfay-Barbe
authors.affiliation: University Center of Pediatric Surgery of Western Switzerland, Division of Pediatric Surgery, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Wildhaber
authors.affiliation: Pediatric Gastroenterology Unit, University Hospitals Geneva, Rue Willy-Donzé 6, 1211, Geneva, Switzerland.
authors.forename: Valérie A
authors.initials: VA
authors.lastname: McLin
mesh_terms: D001424:Bacterial Infections / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide / Q000097:blood; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D010538:Peritonitis / Q000097:blood / Q000175:diagnosis; D011183:Postoperative Complications / Q000097:blood* / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide
keywords: Children; Infection; Liver; Pediatric; Procalcitonin; Transplantation