Procalcitonin for differential diagnosis of graft rejection and infection in patients with heart and/or lung grafts

Objectives: Investigation of the reliability of Pracalcitonin (PCT) for dif ferential diagnosis of acute rejections and non-viral infections in heart a nd lung transplanted patients. Design: Retrospective study. Setting: Transplant intensive care unit (ICU) at a university hospital. Patients: 57 heart, 18 lung and 3 heart-lung transplant patients. Measurements: PCT was measured in plasma samples of heart and lung transpla nted patients using a commercial immune-luminescence assay and was compared with values of C-reactive protein (CRP) and leukocytes (WBC). Results: PCT was elevated in patients suffering from bacterial and fungal i nfections. The magnitude of values was clearly associated with the severity of the infection, Rejections and viral infections did not interfere with t he PCT release. Conclusion: PCT is a reliable predictor with discriminating power for non-v iral systemic infections in patients after heart and/or lung transplantatio n. PCT allows an early differential diagnosis between rejection (AR) and ba cterial/fungal infection (IF) and thus a rapid, and focused therapeutic int ervention.. It avoids unnecessary antibiotic treatment which could be toxic for the graft itself in patients with rejection only. PCT provides vital i nformation early to clinicians and allows them to improve the management of bacterial/fungal infections in immuno-compromized transplant patients. PCT thus facilitates and improves the outcome of survival rate and the quality of life in the postoperative period of patients with heart and/or lung gra fts.