C-Reactive Protein Is an Independent Predictor of 30-Day Bacterial Infection Post-Liver Transplantation

Area of Science:

• Transplantation immunology
• Infectious disease epidemiology
• Biomarker discovery

Background:

• The link between aseptic systemic inflammation and post-surgical bacterial infections remains unclear.
• Postoperative bacterial infections are a significant concern following liver transplantation (LT).

Purpose of the Study:

• To investigate the correlation between systemic inflammation biomarkers and 30-day clinically significant bacterial infections (CSI) after LT.
• To evaluate the predictive value of baseline inflammation markers for CSI post-LT.

Main Methods:

• Retrospective analysis of 940 LT recipients, divided into exploratory (n=508) and validation (n=432) cohorts.
• Utilized Area Under the Receiver Operating Characteristic (AUROC) curves and Cox regression to assess associations.
• Analyzed baseline systemic inflammation markers, including C-reactive protein (CRP).

Main Results:

• A total of 255 bacterial infectious events were recorded in 209 recipients.
• Baseline C-reactive protein (CRP) was independently associated with 30-day CSI in the exploratory cohort.
• The combination of CRP and organ failure number demonstrated strong discrimination for 30-day CSI (AUROC = 0.80), validated externally.
• CRP levels correlated with bacterial product lipopolysaccharide.

Conclusions:

• Pre-transplantation CRP is an independent predictor of 30-day CSI post-LT.
• CRP can be integrated into risk assessment tools or prognostic models for bacterial infection after LT.
• Findings suggest CRP reflects underlying inflammatory states relevant to bacterial susceptibility post-transplant.