Premium
Serial measurement of presepsin, procalcitonin, and C‐reactive protein in the early postoperative period and the response to antithymocyte globulin administration after heart transplantation
Author(s) -
Franeková Janka,
Sečník Peter,
Lavríková Petra,
Kubíček Zdenek,
Hošková Lenka,
Kieslichová Eva,
Jabor Antonín
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12870
Subject(s) - procalcitonin , medicine , biomarker , c reactive protein , sepsis , heart transplantation , gastroenterology , transplantation , globulin , systemic inflammatory response syndrome , immunology , inflammation , biochemistry , chemistry
Differentiation between systemic inflammatory response syndrome and sepsis in surgical patients is of crucial significance. Procalcitonin ( PCT ) and C‐reactive protein ( CRP ) are widely used biomarkers, but PCT becomes compromised after antithymocyte globulin ( ATG ) administration, and CRP exhibits limited specificity. Presepsin has been suggested as an alternative biomarker of sepsis. This study aimed to demonstrate the role of presepsin in patients after heart transplantation ( HT x). Plasma presepsin, PCT , and CRP were measured in 107 patients serially for up to 10 days following HT x. Time responses of biomarkers were evaluated for both noninfected (n=91) and infected (n=16) patients. Areas under the concentration curve differed in the two groups of patients for presepsin ( P <.001), PCT ( P <.005), and CRP ( P <.001). The effect of time and infection was significant for all three biomarkers ( P <.05 all). In contrast to PCT , presepsin was not influenced by ATG administration. More than 25% of noninfected patients had PCT above 42 μg/L on the first day, and the peak concentration of CRP in infected patients was reached on the third post‐transplant day (median 135 mg/L). Presepsin seems to be as valuable a biomarker as PCT or CRP in the evaluation of infectious complications in patients after HT x.