TY - JOUR T1 - C-reactive protein at ICU admission as a marker of early graft dysfunction after liver transplant. A prospective, single-center cohort study JO - Medicina Intensiva T2 - AU - Seller-Pérez,G. AU - Barrueco-Francioni,J.E. AU - Lozano-Sáez,R. AU - Arrebola-Ramírez,M.M. AU - Diez-de-los-Ríos,M.J. AU - Quesada-García,G. AU - Herrera-Gutiérrez,M.E. SN - 02105691 M3 - 10.1016/j.medin.2019.02.009 DO - 10.1016/j.medin.2019.02.009 UR - https://medintensiva.org/es-c-reactive-protein-at-icu-admission-articulo-S0210569119300701 AB - ObjectiveTo explore the behavior of C-reactive protein (CRP) after orthotopic liver transplantation (OLT) during the first postoperative days, and its usefulness as a marker of severe early allograft dysfunction (EAD). DesignA prospective, single-center cohort study was carried out. SettingThe Intensive Care Unit (ICU) of a regional hospital with a liver transplant program since 1997. PatientsThe study comprised a total of 183 patients admitted to our ICU immediately after liver transplantation between 2009 and 2015. Variables of interestC-reactive protein levels upon ICU admission and after 24 and 48h, severe EAD and hospital mortality. ResultsThe CRP levels after OLT were: upon ICU admission 57.5 (51.6–63.3)mg/L, after 24h 80.1 (72.9–87.3)mg/L and after 48h 69.9 (62.5–77.4)mg/L. Severe EAD patients (14.2%) had higher mortality (23.1 vs 2.5; OR 11.48: 2.98–44.19) and lower CRP upon ICU admission (39.3 [29.8–48.7]mg/L) than the patients without EAD (0.5 [53.9–67.0]; p<0.05] – the best cut-off point being 68mg/L (sensitivity 92.3%; specificity 40.1%; Youden index 0.33).Lower CRP upon ICU admission was correlated to higher mortality (24.5 [9.2–39.7] vs 59.4 [53.4–65.4]; p<0.01, AUC 0.79 [0.65–0.92]). ConclusionLiver transplant is a strong inflammatory stimulus accompanied by high levels of C-reactive protein. A blunted rise in CRP on the first postoperative day after OLT may be a marker of poor allograft function and is related to hospital mortality. ER -