Sepsis biomarkers change continuously during the postoperative period. We aimed to demonstrate the influence of immunosuppressants after transplantation (Tx) on presepsin, procalcitonin, CRP, white blood cells, and IL-6. A group of 140 patients after major surgery (86 non-Tx, 54 Tx) without any signs of sepsis or infectious complications was followed for 7 days. The changes in biomarkers were analyzed with respect to the type of surgery, organ, and induction immunosuppressant used (antithymocyte globulin, corticosteroids, or basiliximab/rituximab). Concentrations (95th percentiles) of presepsin and procalcitonin were higher in the Tx group (presepsin: vs. , ; procalcitonin: <28.0 vs. 3.49 μg/L, ). In contrast, CRP and IL-6 were lower in the Tx group (CRP: vs. , ; IL-6: <71.2 vs. 317 ng/L, ). Decreases in CRP and IL-6 were found for all immunosuppressants, and procalcitonin was increased after antithymocyte globulin and corticosteroids. Negligible changes were found for white blood cells. Different responses of presepsin, procalcitonin, CRP, and IL-6 were therefore found in patients without any infectious complications after major surgery or transplantation. Immunosuppression decreased significantly IL-6 and CRP in comparison to non-Tx patients, while procalcitonin was increased after corticosteroids and antithymocyte globulin only. Cautious interpretation of sepsis biomarkers is needed in the early posttransplant period. This work was conducted as a noninterventional (nonregistered) study.

中文翻译：

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移植患者免疫抑制剂给药后脓毒症生物标志物的变化

脓毒症生物标志物在术后期间不断变化。我们旨在证明移植后免疫抑制剂 (Tx) 对预蛋白酶、降钙素原、CRP、白细胞和 IL-6 的影响。对 140 名大手术后（86 名非 Tx，54 名 Tx）没有任何败血症或感染并发症迹象的患者进行了 7 天的随访。根据手术类型、器官和使用的诱导免疫抑制剂（抗胸腺细胞球蛋白、皮质类固醇或巴利昔单抗/利妥昔单抗）分析生物标志物的变化。Tx 组（presepsin： 对比 , ; 降钙素原：<28.0 vs. 3.49  μg /L，）。相比之下，Tx 组的 CRP 和 IL-6 较低（CRP： 对比 , ; IL-6：<71.2 与 317 ng/L，）。所有免疫抑制剂均发现 CRP 和 IL-6 降低，抗胸腺细胞球蛋白和皮质类固醇后降钙素原增加。发现白细胞的变化可以忽略不计。因此，在大手术或移植后没有任何感染并发症的患者中发现了预蛋白酶、降钙素原、CRP 和 IL-6 的不同反应。与非 Tx 患者相比，免疫抑制显着降低了 IL-6 和 CRP，而仅使用皮质类固醇和抗胸腺细胞球蛋白后降钙素原增加。在移植后早期需要谨慎解释脓毒症生物标志物。这项工作是作为一项非干预性（非注册）研究进行的。