To avoid an acute rejection after transplantation, patients receive massive immuno-suppression for weeks. In the case of AR, a maximum dose of steroids as a bolus treatment is also administered. The influence of various immunosuppressive agents on PCT has been explored in different studies.
In septic patients, with and without immunosuppression, PCT does not differ during the first 3 days of the disease. However, immunocompromised patients already show low PCT values between days 3 and 5, while, in patients with a normal immune system, PCT levels do not drop until day 5 . These observations are in complete contrast to reports of exceedingly high PCT values of 103 ng/ml in a 4-year-old liver transplanted girl with disseminated candidiasis who received a combined immunosuppressive therapy consisting of cyclosporin, azathioprine and corticosteroids . PCT was not influenced by these immunosuppressive agents. The only exception appeared to be immunosuppressive therapy with OKT 3, which increased PCT release.
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