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

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Abstract

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 PaO2/FIO2 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 FEV1 (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.

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