Relationship between procalcitonin values and infection in brain-dead organ donors

Transplant Proc. 2007 Dec;39(10):2970-4. doi: 10.1016/j.transproceed.2007.02.101.

Abstract

Background and aims: An association between the inflammatory reactions estimated by several biomarkers and organ dysfunction has been reported in brain-dead organ donors (BDOD). Procalcitonin (PCT), a biomarker of inflammation due to bacterial infection, is increased among BDOD. However, is not known whether infection changes PCT values in BDOD.

Materials and methods: We retrospectively analyzed 82 BDOD including several demographic and clinical parameters, bacterial culture results, antibiotics prescription, and plasma values of PCT measured before organ harvesting. Infection was diagnosed to be either a positive bacterial culture (restricted definition) and/or prescription of antibiotics (extended definition).

Results: The median PCT value was 1.5 (interquartile range [IQR], 0.4 to 6.9; range, 0 to 526 ng/mL; n=82). Thirty-eight (46%) and 24 (29%) patients had PCT values>2 ng/mL and >5 ng/mL, respectively. Median PCT values among infected (1.18; IQR, 0.27 to 6.55 ng/mL) versus noninfected (1.57; IQR, 0.53 to 7.15 ng/mL) BDOD (restricted definition) were not different (P=.36). The area under the receiver operating characteristic curve using PCT to predict infection (restricted definition) was 0.52. Specificity of PCT to predict infection was above 80% at PCT values>9 ng/mL.

Conclusion: Our results confirmed PCT values are increased in BDOD, suggesting that this was not related to an infectious cause (whatever definition was used) unless PCT values are high.

MeSH terms

  • Brain Death*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Cause of Death
  • Graft Rejection / epidemiology*
  • Graft Rejection / mortality
  • Head Injuries, Penetrating
  • Humans
  • Protein Precursors / blood*
  • Tissue Donors / statistics & numerical data*
  • Wounds, Gunshot

Substances

  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • Calcitonin Gene-Related Peptide