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Objective: To explore the behavior of C-reactive protein (CRP) after orthotopic liver transplantation (OLT) during the first postoperative days, and its usefulness as a marker of severe early allograft dysfunction (EAD)., Design: A prospective, single-center cohort study was carried out., Setting: The Intensive Care Unit (ICU) of a regional hospital with a liver transplant program since 1997., Patients: The study comprised a total of 183 patients admitted to our ICU immediately after liver transplantation between 2009 and 2015., Variables of Interest: C-reactive protein levels upon ICU admission and after 24 and 48h, severe EAD and hospital mortality., Results: The CRP levels after OLT were: upon ICU admission 57.5 (51.6-63.3)mg/L, after 24h 80.1 (72.9-87.3)mg/L and after 48h 69.9 (62.5-77.4)mg/L. Severe EAD patients (14.2%) had higher mortality (23.1 vs 2.5; OR 11.48: 2.98-44.19) and lower CRP upon ICU admission (39.3 [29.8-48.7]mg/L) than the patients without EAD (0.5 [53.9-67.0]; p<0.05] - the best cut-off point being 68mg/L (sensitivity 92.3%; specificity 40.1%; Youden index 0.33). Lower CRP upon ICU admission was correlated to higher mortality (24.5 [9.2-39.7] vs 59.4 [53.4-65.4]; p<0.01, AUC 0.79 [0.65-0.92])., Conclusion: Liver transplant is a strong inflammatory stimulus accompanied by high levels of C-reactive protein. A blunted rise in CRP on the first postoperative day after OLT may be a marker of poor allograft function and is related to hospital mortality., (Copyright © 2019 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)

Objective: Comparison of different diagnostic criteria for early liver allograft dysfunction (EAD) and their capability to predict mortality., Design: Single-center, prospective, cohort study., Settings: ICU in a Regional Hospital with a liver transplant program since 1997., Patients: 253 consecutive patients admitted to our ICU immediately after liver transplantation between 2009 and 2015., Variables of Interest: Differences in the incidence of EAD and its relation with ICU, Hospital and 2-year mortality depending on the definition applied using as comparator the UNOS (United Network for Organ Sharing) primary non-function criterion., Results: The incidence of early liver allograft dysfunction according to UNOS was 13.8%, to Makowka 6.3%, to Ardite 10.7%, to Nanashima 20.6%, to Dhillon 30.8% and to MEAF 13.4%. Kappa test did not show a good correlation among these criteria. EAD was related with ICU mortality for all diagnostic criteria except Dhillon but only UNOS, Makowka and MEAF were associated with 2-year mortality. Hospital mortality was poorly predicted by all criteria except for the MEAF score., Conclusion: We found a poor agreement between different criteria analyzed for the diagnosis of EAD. In our population, the MEAF score showed the best relationship with short- and long-term mortality., (Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.)