Diagnostic value of leukocyte count, c-reactive protein, and procalcitonin in pediatric liver transplant patients during the first week postoperative: A longitudinal study from a tertiary center and a new diagnostic method for predicting systemic infection

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dc.authorid0000-0002-7627-7423
dc.authorid0000-0003-3069-2872
dc.authorid0000-0001-9578-9267
dc.authorid0009-0004-5343-8951
dc.authorid0000-0002-1720-9711
dc.authorid0000-0001-6217-1583
dc.authorid0000-0002-3216-2413
dc.authorid0000-0002-0472-8846
dc.authorid0000-0001-7360-628X
dc.authorid0000-0001-6969-9962
dc.contributor.authorÖnal, Zerrin
dc.contributor.authorTürkmen, Elif
dc.contributor.authorDemirkol, Demet
dc.contributor.authorLeblebici, Uğur Can
dc.contributor.authorKandemir, İbrahim
dc.contributor.authorYılmaz, Tuğçe Göksu
dc.contributor.authorTorun, Selda Hançerli
dc.contributor.authorEkiz, Feza
dc.contributor.authorÖzden, Ilgın
dc.contributor.authorDurmaz, Özlem
dc.date.accessioned2025-09-16T08:20:32Z
dc.date.available2025-09-16T08:20:32Z
dc.date.issued2025
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
dc.description.abstractBackground/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 lev els 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 ◦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 ◦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.
dc.identifier.citationÖnal, Z., Türkmen, E., Demirkol, D., Leblebici, U. C., Kandemir, İ., Yılmaz, T. G., Torun, S. H., Ekiz, F., Özden, I., & Durmaz, Ö. (2025). Diagnostic value of leukocyte count, c-reactive protein, and procalcitonin in pediatric liver transplant patients during the first week postoperative: A longitudinal study from a tertiary center and a new diagnostic method for predicting systemic infection. Children, 12(9), pp. 1-12. https://doi.org/10.3390/children12091201
dc.identifier.doi10.3390/children12091201
dc.identifier.endpage12
dc.identifier.issn2227-9067
dc.identifier.issue9
dc.identifier.scopusqualityQ2
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.3390/children12091201
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1109
dc.identifier.volume12
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorKandemir, İbrahim
dc.institutionauthorid0000-0002-1720-9711
dc.language.isoen
dc.publisherMDPI Publishing
dc.relation.ispartofChildren
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectInfection
dc.subjectPediatric Liver Transplantation
dc.subjectProcalcitonin
dc.titleDiagnostic value of leukocyte count, c-reactive protein, and procalcitonin in pediatric liver transplant patients during the first week postoperative: A longitudinal study from a tertiary center and a new diagnostic method for predicting systemic infection
dc.typeArticle
dspace.entity.typePublication

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