Department of Anesthesiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany.
Institute of Medical Biometry and Informatics, Heidelberg University, Im Neuenheimer Feld 130, 69120 Heidelberg, Germany.
Biomolecules. 2022 Jul 15;12(7):989. doi: 10.3390/biom12070989.
After liver transplantation (LTX), patients are susceptible to opportunistic infections resulting in reduced outcomes within the early post-transplantation period. The postoperative monitoring of LTX patients has gained much importance in recent years. However, reliable plasmatic markers predicting 90-day outcomes are still lacking.
In the post hoc analysis of a prospective, observational study, butyrylcholinesterase (BChE), mid-regional proadrenomedullin (MR-proADM), as well as conventional inflammatory markers (procalcitonin, C-reactive protein) were evaluated in 93 patients at seven consecutive timepoints within the first 28 days following LTX.
Persistently reduced activity of BChE and elevated MR-proADM levels indicated reduced 90-day survival following LTX. Furthermore, reduced BChE and increased MR-proADM activity could indicate early post-transplantation bacterial infections, whereas conventional inflammatory biomarkers showed no diagnostic efficacy within the observation period.
Concurrent assessment of BChE and MR-proADM activity might serve as a bedside diagnostic tool for early bacterial infections following liver transplantation. Thus, a combined utilization of the two biomarkers may be a useful tool in the risk evaluation of patients following liver transplantation.
肝移植（LTX）后，患者易发生机会性感染，导致移植后早期结局不佳。近年来，LTX 患者的术后监测受到了高度重视。然而，仍缺乏可预测 90 天结局的可靠血浆标志物。
在一项前瞻性观察研究的事后分析中，在 LTX 后 28 天内的 7 个连续时间点评估了 93 例患者的丁酰胆碱酯酶（BChE）、中区域促肾上腺皮质激素原（MR-proADM）以及常规炎症标志物（降钙素原、C 反应蛋白）。
BChE 活性持续降低和 MR-proADM 水平升高提示 LTX 后 90 天生存率降低。此外，BChE 降低和 MR-proADM 活性增加可能表明移植后早期发生细菌感染，而常规炎症生物标志物在观察期间无诊断效果。
BChE 和 MR-proADM 活性的同时评估可能是肝移植后早期细菌感染的床边诊断工具。因此，两种生物标志物的联合使用可能是肝移植患者风险评估的有用工具。
