Elevated procalcitonin level in early postoperative period after liver transplantation is not an indicator for systemic infection - a case report

Elevated procalcitonin (Pct) in the early postoperative phase after liver transplantation often may present a diagnostic dilemma. We report a 40-year-old patient after deceased donor liver transplant who had elevated Pct on postoperative day (POD) 2 which gradually declined by POD 6. This was not accompanied by any signs of clinical infection and did not coincide with mild rejection in the recipient. We conclude that raised Pct in early posttransplant phase is not an independent marker for systemic infection, whereas persistently elevated Pct level or a second peak may be more contributory to the diagnosis of infection. The level of Pct must be correlated with clinical symptoms, signs, and other infective markers for better diagnostic accuracy.