• G Seller-Pérez, J E Barrueco-Francioni, R Lozano-Sáez, M M Arrebola-Ramírez, M J Diez-de-Los-Ríos, G Quesada-García, and M E Herrera-Gutiérrez.
• Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain.
• Med Intensiva. 2020 Jun 1; 44 (5): 275-282.

ObjectiveTo explore the behavior of C-reactive protein (CRP) after orthotopic liver transplantation (OLT) during the first postoperative days, and its usefulness as a marker of severe early allograft dysfunction (EAD).DesignA prospective, single-center cohort study was carried out.SettingThe Intensive Care Unit (ICU) of a regional hospital with a liver transplant program since 1997.PatientsThe study comprised a total of 183 patients admitted to our ICU immediately after liver transplantation between 2009 and 2015.Variables Of InterestC-reactive protein levels upon ICU admission and after 24 and 48h, severe EAD and hospital mortality.ResultsThe CRP levels after OLT were: upon ICU admission 57.5 (51.6-63.3)mg/L, after 24h 80.1 (72.9-87.3)mg/L and after 48h 69.9 (62.5-77.4)mg/L. Severe EAD patients (14.2%) had higher mortality (23.1 vs 2.5; OR 11.48: 2.98-44.19) and lower CRP upon ICU admission (39.3 [29.8-48.7]mg/L) than the patients without EAD (0.5 [53.9-67.0]; p<0.05] - the best cut-off point being 68mg/L (sensitivity 92.3%; specificity 40.1%; Youden index 0.33). Lower CRP upon ICU admission was correlated to higher mortality (24.5 [9.2-39.7] vs 59.4 [53.4-65.4]; p<0.01, AUC 0.79 [0.65-0.92]).ConclusionLiver transplant is a strong inflammatory stimulus accompanied by high levels of C-reactive protein. A blunted rise in CRP on the first postoperative day after OLT may be a marker of poor allograft function and is related to hospital mortality.Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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