Concurrent Change in Serum Cholinesterase Activity and Midregional-Proadrennomedullin Level Could Predict Patient Outcome following Liver Transplantation

Sebastian O Decker; Albert Krüger; Henryk Wilk; Florian Uhle; Thomas Bruckner; Stefan Hofer; Markus A Weigand; Thorsten Brenner; Aleksandar R Zivkovic

doi:10.3390/biom12070989

Concurrent Change in Serum Cholinesterase Activity and Midregional-Proadrennomedullin Level Could Predict Patient Outcome following Liver Transplantation

Biomolecules. 2022 Jul 15;12(7):989. doi: 10.3390/biom12070989.

Authors

Sebastian O Decker¹, Albert Krüger¹, Henryk Wilk¹, Florian Uhle¹, Thomas Bruckner², Stefan Hofer³, Markus A Weigand¹, Thorsten Brenner^{1

4}, Aleksandar R Zivkovic¹

Affiliations

¹ Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
² Institute of Medical Biometry and Informatics, Heidelberg University, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany.
³ Department of Anesthesiology, Westpfalzklinikum, Kaiserslautern, Hellmut-Hartert-Straße 1, 67655 Kaiserslautern, Germany.
⁴ Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.

Abstract

Background: After liver transplantation (LTX), patients are susceptible to opportunistic infections resulting in reduced outcomes within the early post-transplantation period. The postoperative monitoring of LTX patients has gained much importance in recent years. However, reliable plasmatic markers predicting 90-day outcomes are still lacking.

Methods: In the post hoc analysis of a prospective, observational study, butyrylcholinesterase (BChE), mid-regional proadrenomedullin (MR-proADM), as well as conventional inflammatory markers (procalcitonin, C-reactive protein) were evaluated in 93 patients at seven consecutive timepoints within the first 28 days following LTX.

Results: Persistently reduced activity of BChE and elevated MR-proADM levels indicated reduced 90-day survival following LTX. Furthermore, reduced BChE and increased MR-proADM activity could indicate early post-transplantation bacterial infections, whereas conventional inflammatory biomarkers showed no diagnostic efficacy within the observation period.

Conclusion: Concurrent assessment of BChE and MR-proADM activity might serve as a bedside diagnostic tool for early bacterial infections following liver transplantation. Thus, a combined utilization of the two biomarkers may be a useful tool in the risk evaluation of patients following liver transplantation.

Keywords: liver transplantation; mid-regional proadrenomedullin; outcome; pseudocholinesterase.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
Butyrylcholinesterase
C-Reactive Protein / metabolism
Humans
Liver Transplantation* / adverse effects
Prospective Studies

Substances

Biomarkers
C-Reactive Protein
Butyrylcholinesterase

Associated data

DRKS/DRKS00005480

Grants and funding

The study was conducted with the financial backing of the Department of Anesthesiology (Heidelberg University Hospital, Germany). Furthermore, the primary study received financial grants from the B. Braun Foundation, Melsungen, as well as the Heidelberg Foundation of Surgery. MR-proADM measurements were carried out by Thermo Fisher Scientific (Henningsdorf, Germany).