【Objective】 Serum procalcitonin (PCT) levels transiently elevate during the first few days after both living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT). Although the impact of early-phase serum PCT levels on DDLTs has been researched in other literature, that on LDLTs is still not well clarified.
【Design】 A single-institutional retrospective cohort.
【Methods】 A total of 233 adult primary liver transplantations (205 LDLTs and 28 DDLTs) between 2013 and 2022 were analyzed. Thirty-seven cases were excluded due to the lack of data. We evaluated the first-week transition in serum PCT levels. The impact of serum PCT levels on positive blood cultures of gut microbiota and 1-year graft survival was also analyzed.
【Results】 Pre-transplant serum PCT levels were significantly correlated with the Model for End-Stage Liver Disease score. Serum PCT levels peaked at postoperative day (POD) 2, and the average serum PCT levels at PODs 1-3 were higher in DDLTs (1.99 vs. 11.02 ng/mL, p<0.01). LDLT recipients with high average serum PCT levels at PODs 1-3 (>10 ng/mL) had a lower positive blood culture-free survival within 14 days (70.6 vs. 94.3%, p<0.01). The high average serum PCT levels at PODs 1-3 (>10 ng/mL) were also a significant factor in 1-year graft loss in LDLTs (hazard ratio = 4.17, p=0.03).
【Conclusion】 High serum PCT levels at PODs 1-3 may be a potential predictor of short-term positive blood cultures and graft loss in LDLTs.
