Opportunistic
bacterial infections are dreaded risks in patients following
liver transplantation (LTX), even though patients receive an
antibiotic prophylaxis. The timely recognition of such an
infection may be delayed, as culture-based diagnostic methods are linked with a relevant gap in performance. We measured plasma concentrations of Delta-like canonical Notch
ligand 1 (DLL1) in 93 adult patients at seven consecutive time points after
liver transplantation and correlated the results to the occurrence of culture-proven
bacterial infection or a complicated
clinical course (composite endpoint of two or more complications: graft rejection or failure,
acute kidney failure,
acute lung injury, or 90-day mortality). Patients exhibited elevated plasma concentrations after
liver transplantation over the whole 28 d observation time. Patients with
bacterial infection showed increased DLL1 levels compared to patients without
infection. Persistent elevated levels of DLL1 on day 7 and afterward following LTX were able to indicate patients at risk for a complicated course. Plasma levels of DLL1 following LTX may be useful to support an earlier detection of
bacterial infections in combination with
C-reactive protein (CRP) and
procalcitonin (PCT), or they may lead to risk stratification of patients as a single marker for post-operative complications. (Clinical Trial Notation. German Clinical Trials Register: DRKS00005480).