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Journal of critical care · Apr 2018
Observational StudyProcalcitonin accurately predicts lung transplant adults with low risk of pulmonary graft dysfunction and intensive care mortality.
- Cristopher Mazo, Bárbara Borgatta, Teresa Pont, Alberto Sandiumenge, Silvia Moyano, Antonio Roman, and Jordi Rello.
- Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain; Vall d'Hebron Institut de Recerca, Barcelona, Spain; CIBERES, Instituto de Salud Carlos III, Madrid, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain; Transplant Coordination Department, Vall d'Hebron University Hospital, Barcelona, Spain. Electronic address: cmazo@vhebron.net.
- J Crit Care. 2018 Apr 1; 44: 142-147.
PurposeWe evaluated the association of procalcitonin (PCT), IL-6-8-10 plasma levels during the first 72h after lung transplantation (LT) with ICU-mortality, oxygenation, primary graft dysfunction (PGD), and one-year graft function after LT.Material And MethodsProspective, observational study. PCT and IL-6-8-10 plasma levels were measured at 24h, 48h and 72h after LT from 100 lung transplant recipients (LTr). Patients were followed until one year after LT. End-points were ICU survival, grade 3 PGD at 72h and one-year graft function.ResultsHigher PCT at 24h was associated with lower PaO2/FIO2 ratio and Grade 3 PGD over the first 72h after LT (p<0.05). PCT at 24h was higher in the 9 patients who died (2.90 vs 1.47ng/mL, p<0.05), with AUC=0.74 for predicting ICU-mortality. All patients with PCT<2ng/mL at 24h following LT, survived in the ICU (p<0.05). PCT and IL-10 at 48h were correlated with FEV1 (rho=-0.35) and FVC (rho=-0.29) one year after LT. (p<0.05).ConclusionsA breakpoint of PCT<2ng/mL within 24h has a high predictive value to exclude grade 3 PGD at 72h and for ICU survival. Moreover, both PCT and IL-10 within 48h were associated with significantly better graft function one year after surgery.Copyright © 2017 Elsevier Inc. All rights reserved.
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