Neutrophil CD 64 - Is it an Accurate Marker for Predicting Sepsis in Post LDLT Scenario?

Abstract

Introduction: Sepsis continuous to be a major cause of post op mortality following Liver transplantation[LT]. Survival in sepsis hinges around early diagnosis & source control.Search for early marker for sepsis continues .Expression of Fc receptor CD64 on surface of neutrophils [Ncd64] has been shown in many studies to be an accurate biomarker in detecting sepsis. Methods: Prospective observational study, to evaluate diagnostic accuracy of neutrophil CD64, comparing it with C-reactive protein (CRP) and procalcitonin (PCT) for the diagnosis of sepsis in adult patients undergoing LT.Blood samples were collected D -1, D1, D3, D7. All samples were tested for CRP, PCT & Ncd64 using flow cytometry.Ncd64 values were expressed both as % and mean fluroscence intensity[MFI].Gold standard for diagnosing sepsis was blood/Drain culture positivity. Results: Preliminary results from 24 patients were analysed.In 6 patients who were diagnosed sepsis neither CRP,PCT nor Ncd64 had statistically significant P value in diagnosing sepsis.But while analysing trend of elevation from Baseline to D7, estimation of Ncd64 and CRP looks hopeful in predicting sepsis. Conclusion: As these are preliminary results & study is on-going, role of Ncd64 is yet to be discovered in post LT scenario.Tabled 1Table 1