Perioperative changes of procalcitonin levels in patients undergoing liver transplantation

Abstract

Serum PCT measurement, using appropriate cutoff values, could help diagnose severe infection, and might be able to differentiate bacteremia from acute cellular rejection.

Paradox: Does liver insuffi ciency protect the patient? A hypothesis

“…Ранее было установлено, что содержание ПКТ повышается в крови в течение 6-12 часов после активации воспалительного процесса [47,49]. Мы предполагаем, что предсуществующая порталь-ная гипертензия, пережатие воротной вены в аге-патическом периоде и отсутствие бактериального клиренса клетками Купфера в раннем неогепа-тическом периоде способствуют бактериальной транслокации и антигенемии, что, по нашему мнению, ведет к повышению уровней ПКТ.…”

Pretransplant serum procalcitonin level for prediction of early post‐transplant sepsis in living donor liver transplantation

“…Early recognition of an altered condition, early diagnosis, and prompt treatment with antimicrobial agents in the post‐transplant period are essential for improvement of post‐transplant outcomes. However, accurate and timely diagnosis of sepsis may be difficult due to impaired consciousness after major surgery, immunosuppression therapy, and possible rejection . In addition, results from microbiological cultures can only be obtained after clinical signs of sepsis appear.…”

“…However, accurate and timely diagnosis of sepsis may be difficult due to impaired consciousness after major surgery, immunosuppression therapy, and possible rejection. 6,7 In addition, results from microbiological cultures can only be obtained after clinical signs of sepsis appear. Serum procalcitonin (PCT) is used as a biomarker of bacterial infection and sepsis in a number of areas, and may be useful for early detection of infection and differentiation from non-infectious complications after LT. 6,8,9 However, it is difficult to exclude the effects of highly invasive surgical procedures and post-transplant immunosuppression therapy on the serum PCT level.…”

“…6,7 In addition, results from microbiological cultures can only be obtained after clinical signs of sepsis appear. Serum procalcitonin (PCT) is used as a biomarker of bacterial infection and sepsis in a number of areas, and may be useful for early detection of infection and differentiation from non-infectious complications after LT. 6,8,9 However, it is difficult to exclude the effects of highly invasive surgical procedures and post-transplant immunosuppression therapy on the serum PCT level. 10 Another strategy to improve outcomes is recognizing and eliminating the predictors for post-transplant sepsis during the pretransplant period and transplant surgery.…”

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“…Eyüboğlu and colleagues reported that suspected pulmonary infection is the most common indication for fiberoptic bronchoscopy in transplant recipients, and bronchoscopy may identify the causative organism in > 30% patients. 9 While starting broadspectrum empiric antimicrobial therapy, in addition to local microbiological data, biomarkers such as procalcitonin and galacto-mannan may help as part of a promising diagnostic approach for detecting infection after SOT 10,11 Bacterial pneumonia Pneumonia is the most common lower respiratory tract infection after SOT. Bacterial pneumonia may be nosocomial or community acquired.…”