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Procalcitonin serum levels in patients after liver, pancreas and simultaneous kidney-pancreas transplantations
© BioMed Central Ltd 2006
Published: 21 March 2006
Procalcitonin (PCT) is a reliable measurable marker of the clinical course in patients with infectious complications. Nonspecific elevation of PCT concentrations may occur after major surgeries or multiple trauma. Elevated concentrations of PCT were detected after administration of some immunosuppressive drugs. The aim of our study was compare PCT serum levels in patients after liver, pancreas or simultaneous kidney-pancreas transplantations without any complications.
Patients and methods
PCT serum levels were examined still before induction of anesthesia, at 4 and 8 hours following graft reperfusion, and daily until postoperative day 4. The patients were divided into a group receiving polyclonal antibody ATG Fresnius (21 patients with liver and 10 patients with simultaneous kidney-pancreas transplantation) and one without it (seven patients with liver and three patients with pancreas transplantation). PCT was also determined in 12 patients undergoing liver resection. PCT levels were evaluated using an imunoluminometric assay (ILMA) with a LUMItest PCT kit (Brahms Diagnostics, Berlin, Germany) with monoclonal antibodies against calcitonin and katacalcin sequences, part of the PCT molecule.
PCT serum levels were slightly elevated (up to 13.90 ng/ml) in several patients after liver transplantation without ATG therapy. PCT was strongly induced in most cases in patients after liver transplantation with ATG administration (up to 249.10 ng/ml). The mean value of the maximum PCT concentration on the first postoperative day was 4.49 ± 1.63 ng/ml in patients after liver transplantation without ATG therapy and 59.08 ± 12.60 ng/ml in patients with ATG therapy (P < 0.001). In addition, both groups are compared with 12 patients undergoing liver resection, whose mean serum PCT levels did not exceed 1.41 ± 0.29 ng/ml. Low PCT serum concentrations (0.46 ± 0.10 ng/ml) occurred in patients after pancreas transplantation without ATG treatment. A very marked increase (139 ± 49.08) in serum PCT levels was recorded in patients with simultaneous kidney-pancreas transplantation with ATG administration.
Polyclonal antibody administration to patients with liver and simultaneous kidney-pancreas transplantation is associated with a very marked increase in serum PCT levels, with peak values on postoperative day 1. However, this is without a clinical correlate in the form of a severe inflammatory response. The possible PCT release following ATG therapy should be taken into account when using this inflammatory parameter in transplant patients.