Monitoring in liver transplantation

Introduction

Despite the overall acceptable results obtained in liver transplantation during the last 15 years infection and the appropriate management of the immunosuppressive treatment remains a major issue in the follow-up and outcome after liver transplantation.

Patients and methods

One hundred liver transplants with a 1 year survival rate of 81% were performed at the university of Leipzig since December 1993. Patients were monitored beside the routine laboratory parameters by Procalcitonin (PCT), soluble IL-2-receptor (s-IL2-R) TNF alpha, Interleukin 6 (IL-6) and Interleukin 8 (IL-8). The postoperative complications were differentiated whether a gram- or + sepsis or a fungal infection occurred.

Results

See Table.

Conclusion

These qualitatively summarized results indicate the potential role of an advanced monitoring for the differentiation of infectious complications. Elevated PCT, IL-6 and s-IL-2 R levels are found in severe bacterial infections, whereas very high levels of TNF alpha and s-IL-2 R seem to be more specific for fungal infections. These findings may be a useful guide for the initiation of a specific diagnostic work up, for the induction of an adequate treatment and/or for an appropriate modification of the immuno-suppressive treatment.

Table