Diagnostic value of serum procalcitonin for early postoperative bacterial infection after pediatric ;living donor liver transplantation

Abstract

Objective To analyze the diagnostic value of serum procalcitonin (PCT) for early postoperative bacterial infection after pediatric living donor liver transplantation. Methods A retrospective study was conducted in pediatric patients after living donor liver transplantation recipients admitted to department of critical care medicine of Beijing Friendship Hospital affiliated to Capital Medical University during June 2013 to October 2015. According to the clinical data, all pediatric patients were divided into infection group(n=60) and non-infection group (n=100). Primary disease, PCT post operation day 1 to day 5 for non-infection group and day 1 to day 9 for infection group, temperature, white blood cell, cold ischemia time, warm ischemia time, operation time, volume of blood loss during operation were recorded. All parameters above were compared between groups. Receiver operating characteristic (ROC) curve was plotted, and the diagnostic value of PCT was evaluated. Results PCT of both groups were elevated after liver transplantation, there was a markedly resolution in non-infection group within 48 to 72 hours.PCT of pediatric patients with bacterial infection was significantly higher than that of non-infected patients, and the difference was of greatly significant (4.62±1.39) ng/ml vs (0.85±0.19) ng/ml, t=26.56, P=0.00. ROC curve showed that the peak level of PCT might be valuable in the diagnosis of bacterial infection(AUC=0.985). There was no significant difference of cold ischemia time[(109.92±19.22) min vs (108.04±13.20) min, t=1.05, P=0.29], warm ischemia time[(1.49±0.17) min vs (1.52±0.12) min, t=1.08, P=0.28], operation time[(8.01±0.77)vs (8.00±1.05) h, t=0.06, P=0.94], WBC[(8.95±1.69)×109/L vs (8.98±2.00)×109/L, t=-0.08, P=0.93]and body temperature[(37.5±0.7) vs (37.5±0.8) ℃, t=-0.05, P=0.96]on the first day after surgery between infection and non-infection groups. Amount of bleeding in infection group was higher than that of non infection group[(650.87±90.36) ml vs (240.29±67.67) ml, t=32.33, P=0.00], there was longer length of ICU stay in the infection group[(11.01±1.81)d vs (6.03±1.65)d, t=17.78, P=0.00]. Conclusion Peak PCT level was a valuable indicator for early postoperative bacterial infection after pediatric living donor liver transplantation.(Chin J Lab Med, 2017, 40: 46-49) Key words: Bacterial infections; Liver transplantation; Procalcitonin