1. Positive Role of Procalcitonin Level in the Diagnosis of Infectious Diseases After Liver Transplantation
- Author
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Mohsen Nasiri-Toosi, Leila Jahan, Zinat Mohammadpour, Bobak Moazzami, Zahra Ahmadinejad, Simin Dashti-Khavidaki, Fereshteh Ghiasvand, Zeynab Malekzadeh, and Amirpasha Ebrahimi
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Liver transplantation ,medicine.disease ,Gastroenterology ,Procalcitonin ,Sepsis ,Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Internal medicine ,parasitic diseases ,medicine ,Postoperative infection ,Diagnostic biomarker ,030211 gastroenterology & hepatology ,030212 general & internal medicine ,business ,Complication ,Prospective cohort study ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background: Procalcitonin (PCT) has been shown as a reliable diagnostic biomarker for identifying sepsis and bacterial infection. Objectives: The present study examined the sensitivity and specificity of PCT evaluation in the diagnosis of infectious diseases after liver transplantation. Methods: The present prospective cohort study was conducted on postoperative liver transplant (LT) patients in the liver transplant ward of Imam Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences between January 2014 and March 2015. Serum PCT levels were evaluated before transplantation and one, two, and six or seven days post-operation by semi-quantitative kits with a 30 seconds response. Results: A total number of 28 LT patients were enrolled in this study. The mean patients’ ages were 48.6 ± 10.9 (range 26 - 66) years old. Serum PCT levels in all patients were < 0.5 ng/mL prior to the operation. At first and second days post-operation, PCT levels were more than 2 ng/mL in all patients and decreased to 0.5 ng/mL after 6 or 7 days in 23 patients. Serum PCT level of higher than 5 ng/mL on the first and second days post-surgery with a sensitivity of 77.8% and specificity of 79% had the most accuracy for the infection diagnosis. The PCT level more than 5 ng/mL in the sixth and seventh days had a 100% positive predictive value in the infection prediction. Conclusions: Serial evaluations of serum PCT after liver transplantation had good sensitivity and specificity to predict postoperative infection. Increased serum PCT level within the first days after transplantation and/or failure to decrease after one week, predicts infectious complications and undesirable outcome.
- Published
- 2019