C-reactive protein at ICU admission as a marker of early graft dysfunction after liver transplant. A prospective, single-center cohort study
| Autor: | M.E. Herrera-Gutiérrez, G. Seller-Pérez, R. Lozano-Sáez, M.J. Diez-de-los-Ríos, M.M. Arrebola-Ramirez, J.E. Barrueco-Francioni, Guillermo Quesada-García |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Liver transplantation Critical Care and Intensive Care Medicine Single Center Gastroenterology law.invention Cohort Studies 03 medical and health sciences 0302 clinical medicine law Internal medicine medicine Humans Prospective Studies medicine.diagnostic_test APACHE II biology business.industry C-reactive protein Postoperative complication 030208 emergency & critical care medicine Middle Aged Intensive care unit Liver Transplantation Hospitalization C-Reactive Protein 030228 respiratory system biology.protein Female Primary Graft Dysfunction Liver function tests business Biomarkers Cohort study |
| Zdroj: | Medicina Intensiva (English Edition). 44:275-282 |
| ISSN: | 2173-5727 |
| Popis: | To explore the behavior of C-reactive protein (CRP) after orthotopic liver transplantation (OLT) during the first postoperative days, and its usefulness as a marker of severe early allograft dysfunction (EAD).A prospective, single-center cohort study was carried out.The Intensive Care Unit (ICU) of a regional hospital with a liver transplant program since 1997.The study comprised a total of 183 patients admitted to our ICU immediately after liver transplantation between 2009 and 2015.C-reactive protein levels upon ICU admission and after 24 and 48h, severe EAD and hospital mortality.The CRP levels after OLT were: upon ICU admission 57.5 (51.6-63.3)mg/L, after 24h 80.1 (72.9-87.3)mg/L and after 48h 69.9 (62.5-77.4)mg/L. Severe EAD patients (14.2%) had higher mortality (23.1 vs 2.5; OR 11.48: 2.98-44.19) and lower CRP upon ICU admission (39.3 [29.8-48.7]mg/L) than the patients without EAD (0.5 [53.9-67.0]; p0.05] - the best cut-off point being 68mg/L (sensitivity 92.3%; specificity 40.1%; Youden index 0.33). Lower CRP upon ICU admission was correlated to higher mortality (24.5 [9.2-39.7] vs 59.4 [53.4-65.4]; p0.01, AUC 0.79 [0.65-0.92]).Liver transplant is a strong inflammatory stimulus accompanied by high levels of C-reactive protein. A blunted rise in CRP on the first postoperative day after OLT may be a marker of poor allograft function and is related to hospital mortality. |
| Databáze: | OpenAIRE |
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