Procalcitonin accurately predicts lung transplant adults with low risk of pulmonary graft dysfunction and intensive care mortality

• Published in: Journal of critical care Vol. 44; pp. 142 - 147
• Main Authors: Mazo, Cristopher, Borgatta, Bárbara, Pont, Teresa, Sandiumenge, Alberto, Moyano, Silvia, Roman, Antonio, Rello, Jordi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2018; Elsevier Limited
• Subjects: Adult; Biomarkers; Biomarkers - blood; Blood; Chemokines; Critical Care - statistics & numerical data; Cytokines; Female; Hospital Mortality; Humans; Infections; Infectious diseases; Intensive care; Intensive Care Units - statistics & numerical data; Interleukins - blood; Lung transplantation; Lung Transplantation - statistics & numerical data; Lung transplants; Male; Middle Aged; Mortality; Multivariate Analysis; Odds Ratio; Oxygen - blood; Predictive Value of Tests; Primary graft dysfunction; Primary Graft Dysfunction - blood; Procalcitonin; Procalcitonin - blood; Prospective Studies; Pulmonary fibrosis; Surgery; Systematic review; Thoracic surgery; Transplants & implants; Variables; PCT; Primary graft dysfunction; Procalcitonin; Lung transplantation; LT; BLT; AUC; SLT; OR; 48h; CI; 24h; Mortality; LTr; IL-8; PGD; Admission time; 72h; IL-6; IL-10; CPB; PF; Biomarkers; ICU; COPD
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2017.10.047

We 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.
Prospective, 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.
Higher 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).
A 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.
•PCT at 24h after LT was negatively associated with PaO2/FIO2 ratio.•PCT<2ng/mL at 24h after LT excluded grade 3 PGD at 72h and ICU mortality.•PCT and IL-10 at 48h after LT were associated with better graft function 1year after surgery.