TY - JOUR
T1 - Procalcitonin accurately predicts lung transplant adults with low risk of pulmonary graft dysfunction and intensive care mortality
AU - Mazo, Cristopher
AU - Borgatta, Bárbara
AU - Pont, Teresa
AU - Sandiumenge, Alberto
AU - Moyano, Silvia
AU - Roman, Antonio
AU - Rello, Jordi
PY - 2018/4/1
Y1 - 2018/4/1
N2 - © 2017 Elsevier Inc. Purpose: We evaluated the association of procalcitonin (PCT), IL-6-8-10 plasma levels during the first 72 h after lung transplantation (LT) with ICU-mortality, oxygenation, primary graft dysfunction (PGD), and one-year graft function after LT. Material and methods: Prospective, observational study. PCT and IL-6-8-10 plasma levels were measured at 24 h, 48 h and 72 h 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 72 h and one-year graft function. Results: Higher PCT at 24 h was associated with lower PaO 2 /F I O 2 ratio and Grade 3 PGD over the first 72 h after LT (p < 0.05). PCT at 24 h was higher in the 9 patients who died (2.90 vs 1.47 ng/mL, p < 0.05), with AUC = 0.74 for predicting ICU-mortality. All patients with PCT < 2 ng/mL at 24 h following LT, survived in the ICU (p < 0.05). PCT and IL-10 at 48 h were correlated with FEV 1 (rho = − 0.35) and FVC (rho = − 0.29) one year after LT. (p < 0.05). Conclusions: A breakpoint of PCT < 2 ng/mL within 24 h has a high predictive value to exclude grade 3 PGD at 72 h and for ICU survival. Moreover, both PCT and IL-10 within 48 h were associated with significantly better graft function one year after surgery.
AB - © 2017 Elsevier Inc. Purpose: We evaluated the association of procalcitonin (PCT), IL-6-8-10 plasma levels during the first 72 h after lung transplantation (LT) with ICU-mortality, oxygenation, primary graft dysfunction (PGD), and one-year graft function after LT. Material and methods: Prospective, observational study. PCT and IL-6-8-10 plasma levels were measured at 24 h, 48 h and 72 h 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 72 h and one-year graft function. Results: Higher PCT at 24 h was associated with lower PaO 2 /F I O 2 ratio and Grade 3 PGD over the first 72 h after LT (p < 0.05). PCT at 24 h was higher in the 9 patients who died (2.90 vs 1.47 ng/mL, p < 0.05), with AUC = 0.74 for predicting ICU-mortality. All patients with PCT < 2 ng/mL at 24 h following LT, survived in the ICU (p < 0.05). PCT and IL-10 at 48 h were correlated with FEV 1 (rho = − 0.35) and FVC (rho = − 0.29) one year after LT. (p < 0.05). Conclusions: A breakpoint of PCT < 2 ng/mL within 24 h has a high predictive value to exclude grade 3 PGD at 72 h and for ICU survival. Moreover, both PCT and IL-10 within 48 h were associated with significantly better graft function one year after surgery.
KW - Biomarkers
KW - Lung transplantation
KW - Mortality
KW - Primary graft dysfunction
KW - Procalcitonin
U2 - 10.1016/j.jcrc.2017.10.047
DO - 10.1016/j.jcrc.2017.10.047
M3 - Article
SN - 0883-9441
VL - 44
SP - 142
EP - 147
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -