Prediction of gross post-transplant outcomes based on the intra-operative decline in C-reactive protein in living donor liver transplantation

Transplantation Proceedings
H S ChungC Park

Abstract

C-reactive protein (CRP), a marker of infection and inflammation, is produced mainly in the liver. Its slow onset and various influencing factors have limited studies on the intra-operative changes in CRP in living donor liver transplantation (LDLT). In this study, we asked whether the intra-operative changes in CRP predicts post-transplant outcome. The peri-transplant data of 263 LDLT patients were reviewed. "Intra-operative CRP decline" was calculated by subtracting the pretransplant CRP from the 1-day post-transplant CRP. A negative value defined an intra-operative decline. Peri-transplant variables were compared between patients with and without gross post-transplant outcomes (GPOs), including death, allograft dysfunction, infection, and kidney injury. Multivariate logistic regression was used to develop a model to predict GPO, and area receiver operating characteristic curve (AUC) analysis was used to evaluate the prognostic accuracies for GPO. GPOs were determined in 95 LDLT patients (36.1%). GPO-positive patients had a lesser change in CRP levels (0.51 versus 1.16 mg/dL) and a higher incidence of a decline in CRP (34.7% versus 13.7%) during LDLT (P < .05) than did GPO-negative patients. The AUC of the intra-operative CRP...Continue Reading

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