Association Between Serum C-Reactive Protein and Albumin Levels and Psychiatric Comorbidities in Liver Transplant Recipients

Background

Orthotopic liver transplantation (OLT) is the definitive treatment for patients with end-stage liver disease. Many post-OLT patients have psychiatric comorbidities. The relationship between psychiatric comorbidities and biological factors, such as C-reactive protein (CRP) and albumin levels, in OLT recipients has seldom been investigated.

Methods

We analyzed medical charts of all patients aged over 18 who underwent orthotopic OLT at a tertiary medical center between September 2008 and July 2010 for serum CRP and albumin levels before and 1 month after OLT. Data for baseline characteristics, such as gender, age, and body mass index (BMI), were also collected. Patients who had a psychiatric consultation or took psychotropic medications during the hospitalization were categorized as “with psychiatric comorbidities.”

Results

Psychiatric comorbidities existed in 51 (33.8%) of 151 OLT recipients. By analysis of covariance adjusted for age and BMI, post-OLT CRP levels in patients with psychiatric comorbidities were significantly higher than those without psychiatric comorbidities (P = .015). For patients with psychiatric comorbidities, the paired t test showed significantly increased CRP levels at 1 month after when compared to the pre-OLT baseline levels (P = .044). Patients without psychiatric comorbidities had significantly decreased CRP levels at 1 month after when compared with the pre-OLT baseline levels (P = .009).

Conclusions

Elevated CRP levels may indicate activation of a systemic inflammatory process caused by psychiatric comorbidities in OLT recipients.