Association of postoperative day 1 procalcitonin levels with short-term mortality after liver transplantation: a single-center retrospective cohort study

Postoperative complications, especially infections, are important causes of poor prognosis after liver transplantation. Procalcitonin (PCT) has been proven to be a sensitive marker of infection and inflammation in many diseases. As a result, the purpose of this study was to determine the connection between early postoperative PCT levels and mortality in liver transplant patients. We included 205 liver transplant recipients who underwent orthotopic allogeneic liver transplantation at Sun Yat-sen University’s Sun Yat-sen Memorial Hospital. We grouped the patients according to the tertile of PCT levels on postoperative day one (POD 1) and divided the patients into three groups: Q1 (≤ 2.0 ng/ml), Q2 (2.1–5.0 ng/ml), and Q3 (≥ 5.1 ng/ml). To analyze the curvilinear association between PCT levels and 90-day mortality and in-hospital mortality, we used Spearman’s rank correlation coefficient. The Kaplan-Meier method was used to assess survival rates at 30, 60 and 90 days after liver transplantation. The Log-rank test was used to analyze differences in survival rates between different PCT groups. Higher POD1 PCT levels were associated with increased 90-day and in-hospital mortality. Furthermore, this study revealed a statistically significant decrease in ICU-free days at 28-day, hospital-free days at 28-day, CRRT-free hours at 28-day, and hospital-free days at 60-day among patients in the group of high PCT level. Higher POD1 PCT levels were associated with worse short-term postoperative outcomes after liver transplantation. However, POD1 PCT should be interpreted as a potential early risk-associated biomarker rather than as an established independent prognostic factor.