TY - JOUR
T1 - Prediction of gross post-transplant outcomes based on the intra-operative decline in C-reactive protein in living donor liver transplantation
AU - Chung, H. S.
AU - Kim, E. S.
AU - Park, J. H.
AU - Park, C. S.
N1 - Publisher Copyright:
© 2015 Elsevier Inc. All rights reserved.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background 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. Methods 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. Results 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 change (0.585; P =.018) did not significantly differ from that of the pretransplant CRP. After multivariate adjustment, a patient with an intra-operative decline in CRP had a 3.21-fold higher risk for GPO occurrence (P =.001). Conclusions GPO occurrence was related to the intra-operative decline of CRP in LDLT patients. However, multivariate compensation might be required for the clinical utilization of intra-operative decline in CRP as a prognostic indicator.
AB - Background 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. Methods 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. Results 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 change (0.585; P =.018) did not significantly differ from that of the pretransplant CRP. After multivariate adjustment, a patient with an intra-operative decline in CRP had a 3.21-fold higher risk for GPO occurrence (P =.001). Conclusions GPO occurrence was related to the intra-operative decline of CRP in LDLT patients. However, multivariate compensation might be required for the clinical utilization of intra-operative decline in CRP as a prognostic indicator.
UR - http://www.scopus.com/inward/record.url?scp=84926193030&partnerID=8YFLogxK
U2 - 10.1016/j.transproceed.2015.01.005
DO - 10.1016/j.transproceed.2015.01.005
M3 - Article
C2 - 25769586
AN - SCOPUS:84926193030
SN - 0041-1345
VL - 47
SP - 431
EP - 437
JO - Transplantation Proceedings
JF - Transplantation Proceedings
IS - 2
ER -