Akademik Veri Yönetim Sistemi
CHILDREN-BASEL, cilt.12, sa.9, 2025 (SCI-Expanded)
Highlights Infectious complications are the most feared and serious problems in children undergoing liver transplantation caused by immunosuppression. Inflammatory markers rise early after the transplant due to both infection and surgical stress, which can create diagnostic challenges. Therefore, timely diagnosis of infections and prompt treatment are crucial. However, ruling out non-infectious causes is also important to prevent unnecessary antibiotic use and colonization by resistant microorganisms. What are the main findings? Procalcitonin levels were significantly elevated on the 1st, 4th, and 7th days, while WBC levels were only elevated on the 7th day in patients with culture-positive bacterial infections. First day body temperature of >= 37.1 degrees C and a PCT of >= 5.1 ng/dL had 72.2% sensitivity and 84.3% specificity for bacterial growth, while a body temperature of >= 37.1 degrees C and a PCT of >= 9.2 ng/dL showed 73% sensitivity and 95% specificity for SIRS. What is the implication of the main finding? The diagnosis of infection in pediatric LT patients increases with higher PCT levels and body temperature on the first day. We also saw the same pattern in patients with SIRS. Additionally, while PCT elevation was a significant indicator of bacterial growth, CRP and WBC values were not reliable for detecting infection. Elevated PCT levels and a body temperature of >= 37.1 degrees C on the first day may indicate bacterial growth and SIRS.Highlights Infectious complications are the most feared and serious problems in children undergoing liver transplantation caused by immunosuppression. Inflammatory markers rise early after the transplant due to both infection and surgical stress, which can create diagnostic challenges. Therefore, timely diagnosis of infections and prompt treatment are crucial. However, ruling out non-infectious causes is also important to prevent unnecessary antibiotic use and colonization by resistant microorganisms. What are the main findings? Procalcitonin levels were significantly elevated on the 1st, 4th, and 7th days, while WBC levels were only elevated on the 7th day in patients with culture-positive bacterial infections. First day body temperature of >= 37.1 degrees C and a PCT of >= 5.1 ng/dL had 72.2% sensitivity and 84.3% specificity for bacterial growth, while a body temperature of >= 37.1 degrees C and a PCT of >= 9.2 ng/dL showed 73% sensitivity and 95% specificity for SIRS. What is the implication of the main finding? The diagnosis of infection in pediatric LT patients increases with higher PCT levels and body temperature on the first day. We also saw the same pattern in patients with SIRS. Additionally, while PCT elevation was a significant indicator of bacterial growth, CRP and WBC values were not reliable for detecting infection. Elevated PCT levels and a body temperature of >= 37.1 degrees C on the first day may indicate bacterial growth and SIRS.Highlights Infectious complications are the most feared and serious problems in children undergoing liver transplantation caused by immunosuppression. Inflammatory markers rise early after the transplant due to both infection and surgical stress, which can create diagnostic challenges. Therefore, timely diagnosis of infections and prompt treatment are crucial. However, ruling out non-infectious causes is also important to prevent unnecessary antibiotic use and colonization by resistant microorganisms. What are the main findings? Procalcitonin levels were significantly elevated on the 1st, 4th, and 7th days, while WBC levels were only elevated on the 7th day in patients with culture-positive bacterial infections. First day body temperature of >= 37.1 degrees C and a PCT of >= 5.1 ng/dL had 72.2% sensitivity and 84.3% specificity for bacterial growth, while a body temperature of >= 37.1 degrees C and a PCT of >= 9.2 ng/dL showed 73% sensitivity and 95% specificity for SIRS. What is the implication of the main finding? The diagnosis of infection in pediatric LT patients increases with higher PCT levels and body temperature on the first day. We also saw the same pattern in patients with SIRS. Additionally, while PCT elevation was a significant indicator of bacterial growth, CRP and WBC values were not reliable for detecting infection. Elevated PCT levels and a body temperature of >= 37.1 degrees C on the first day may indicate bacterial growth and SIRS.Abstract Background/Objectives: Infection is a major complication during the early postoperative period following pediatric liver transplantation (LT). Prompt diagnosis and treatment are essential to prevent death. We aimed to assess the diagnostic value of procalcitonin (PCT), white blood cell count (WBC), and C-reactive protein (CRP) levels for detecting bacterial infection and SIRS within the first week after LT. Methods: Demographic data, vital signs, laboratory results (PCT, CRP, WBC), and culture findings on the 1st, 4th, and 7th days between January 2010 and 2024 were collected retrospectively. Results: The study included 88 patients. Seventy-two percent had cirrhotic liver disease. SIRS was present in 17% (n = 15), and bacterial growth was detected in 20% (n = 18). Bacterial growth was found in 80% of patients with SIRS (n = 12/15) and in 8% of SIRS-negative patients (n = 6/73). PCT levels were significantly elevated on days 1, 4, and 7, and CRP levels on days 4 and 7 in patients with SIRS. PCT elevation was significant on days 1, 4, and 7, while WBC increase was noted on day 7 in patients with bacterial growth. Body temperature >= 37.1 degrees C and PCT >= 5.1 ng/dL on the first day together showed a sensitivity of 72.2% and specificity of 84.3% for bacterial growth. Similarly, body temperature >= 37.1 degrees C and PCT >= 9.2 ng/dL on the first day yielded 73% sensitivity and 95% specificity for diagnosing SIRS. Cirrhotic patients exhibited limited or no WBC response to bacterial growth. Conclusions: PCT, CRP, and WBC alone are insufficient for diagnosing infection. Combined assessment of body temperature changes and PCT elevation may serve as more accurate indicators. Nonetheless, close monitoring of culture results and clinical signs, with serial physical exams, can aid timely infection management or prevent unnecessary antibiotic adjustments.