C-reactive protein at ICU admission as a marker of early graft dysfunction after liver transplant. A prospective, single-center cohort study.
Med Intensiva (Engl Ed)
; 44(5): 275-282, 2020.
Article
em En, Es
| MEDLINE
| ID: mdl-31000214
ABSTRACT
OBJECTIVE:
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).DESIGN:
A prospective, single-center cohort study was carried out.SETTING:
The Intensive Care Unit (ICU) of a regional hospital with a liver transplant program since 1997. PATIENTS The study comprised a total of 183 patients admitted to our ICU immediately after liver transplantation between 2009 and 2015. VARIABLES OF INTEREST C-reactive protein levels upon ICU admission and after 24 and 48h, severe EAD and hospital mortality.RESULTS:
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]; p<0.05] - 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]; p<0.01, AUC 0.79 [0.65-0.92]).CONCLUSION:
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.Palavras-chave
Biomarcador; Biomarker; C-reactive protein; Complicación postoperatoria; Disfunción primaria del injerto; Disfunción temprana del injerto; Early allograft dysfunction; Liver function test; Outcome; Postoperative complication; Primary graft dysfunction; Proteína C reactiva; Pruebas de función hepática; Resultado
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteína C-Reativa
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Transplante de Fígado
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Disfunção Primária do Enxerto
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Med Intensiva (Engl Ed)
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Espanha