Zeitschrift für Hepatologie und Magen-Darm-Erkrankungen
Offener Zugang

Abstrakt

Perioperative White Blood Cell Count as a Marker for Patient and Graft Survival after Orthotopic Liver Transplantation

Helfritz FA, Lehner F, Manns MP, Klempnauer J and Ciesek S

Background: Orthotopic liver transplantation (OLT) is a standard procedure in end stage liver disease. However, recipients of OLT have a 10-15% risk to die within one year after transplantation. We evaluated whether different parameters of infection including inflammatory markers and white blood cells (WBC) predict post-OLT mortality, graft survival and rate of acute rejection.
Methods: We collected clinical and laboratory data of 102 patients undergoing liver transplantation between 2011 and 2012 Hannover Medical School. Patients were stratified by i) patient survival, ii) graft survival and iii) episode of rejection(s) and were followed from OLT for one year. Laboratory data of peritransplant period (0-4 days after OLT) were analyzed.
Results: Inflammatory markers like CRP and procalcitonin had no significant effect on one-year patient or graft survival after OLT (p=0.3 or p=0.8 respectively). Interestingly, WBC early after OLT was a prognostic marker for patients (p=0.019) and graft survival (p=0.03). Importantly, white blood cell count early after OLT was independent from rate of acute rejection episodes. White blood cell count >20.000/μl within the first four days after OLT was associated with a higher patient and graft mortality. Patient mortality was 30% (WBC >20.000/μl) in comparison to 13% (WBC <20.000/μl). These results were independent from the underlying liver disease or type of immunosuppressive regimen.
Conclusions: These data demonstrate that white blood cell count >20.000/μl early after OLT is a cheap prognostic marker for patient and graft survival, while perioperative procalcitonin and CRP levels have no influence.