DOI: https://doi.org/10.22263/2312-4156.2026.3.52
A.L. Lipnitski1,2, A.V. Marochkov1,2
Procalcitonin levels in potential donors with brain death
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2026;25(3):52-59.
Abstract.
Determining the presence of infection in brain-dead donors (BD) is a highly relevant and challenging task, due to the presence of a pronounced systemic inflammatory response caused by severe brain injury. Therefore, the objective was to determine the dynamics of procalcitonin (PCT) levels in potential BD donors during protective intensive care.
Material and methods. A total of 122 BD donors were included in this prospective study. The donors were 53 (43; 59) years old. There were 79 (65%) male and 43 (35%) female donors. The diagnoses leading to BD were: non-traumatic intracranial hemorrhage (n=82 (67%)); ischemic brain injury (n=18 (15%)); and traumatic brain injury (n=22 (18%)). PCT levels and other laboratory parameters were analyzed at three stages: Stage 1 – after the first consultation to determine BD; Stage 2 – 12-24 hours after the 1st consultation; Stage 3 – after the 2nd consultation to determine BD.
Results. PCT levels at Stage 1 were higher than the reference values – 2.12 (0.56; 7.95) ng/ml. At Stage 2 of the study, no statistically significant change in PCT levels was detected – 2.1 (0.61; 5.12) ng/ml (p>0.1). PCT levels at Stage 3 did not change statistically significantly compared to Stages 1 and 2 – 2.37 (0.74; 5.91) ng/ml (p>0.1). The average PCT level in donors with BD across all stages of the study was 2.09 (0.65; 6.5) ng/ml. A total of 68 (56%) potential donors had PCT levels above 2 ng/ml during protective intensive care, and 27 (22%) donors had levels above 10 ng/ml. Correlation analysis revealed a moderate negative correlation between PCT values at stage 3 and the duration of intensive care prior to the determine BD (R=-0.38, p<0.0001), as well as with the duration of intensive care prior to organ and tissue retrieval (R=-0.37, p<0.0001).
Conclusions. The obtained data showed that 56% of potential donors had PCT levels above 2 ng/ml, and the average PCT level across all donors was 2.09 (0.65; 6.5) ng/ml.
Keywords: PCT, procalcitonin, brain death, systemic inflammation, brain injury, potential donor, transplantation.
Information on the source of support in the form of grants, equipment, and medications. The research is being conducted under a grant from the President of the Republic of Belarus in healthcare, “Development and implementation in clinical practice of a new method for diagnosing and correcting macro- and microelement imbalances during medical care of potential organ and tissue donors” (Order of the President of the Republic of Belarus dated December 30, 2025, No. 200рп).
References
1. Shcherba AE, Kuzmenkova LL, Efimov DY, Nosik AV, Prilutsky PS, Korotkov SV, et al. Risk factors and prediction of bacterial complications in liver transplantation. Annaly khirurgicheskoy gepatologii. 2023;28(3):10-20. (In Russ.). doi: http://dx.doi.org/10.16931/1995-5464.2023-3-10-20
2. Kalachik OV. Donor-dependent risk factors for the development of early allograft dysfunction in cadaveric kidney transplantation. Meditsinskie novosti. 2018;(4):37-41. (In Russ.)
3. Kaul DR, Vece G, Blumberg E, La Hoz RM, Ison MG, Green M, et al. Ten years of donor-derived disease: A report of the disease transmission advisory committee. American Journal of Transplantation. 2021 Feb;21(2):689-702. doi: http://dx.doi.org/10.1111/ajt.16178
4. Salimov UR, Shcherba AE, Rummo OO. Bacterial complications after liver transplantation. Prospects for further research. Transplantologiya. 2023;15(2):238-250. (In Russ.). doi: http://dx.doi.org/10.23873/2074-0506-2023-15-2-238-250
5. Lipnitski AL, Marochkov AV. C-reactive protein as an indicator of inflammation and infection in brain-dead donors. Vestnik transplantologii i iskusstvennykh organov. 2025;27(3):232-237. (In Russ.). doi: http://dx.doi.org/10.15825/1995-1191-2025-3-232-237
6. Schwarz P, Custódio G, Rheinheimer J, Crispim D, Leitão CB, Rech TH. Brain death-induced inflammatory activity is similar to sepsis-induced cytokine release. Cell transplantation. 2018;27(10):1417-1424. doi: http://dx.doi.org/10.1177/0963689718785629.
7. Hamade B, Huang DT. Procalcitonin: Where Are We Now? Critical care clinics. 2020;36(1):23-40. doi: http://dx.doi.org/10.1016/j.ccc.2019.08.003
8. Lipnitski AL, Marochkov AV, Kupreeva IA. Dynamics of serum iron levels in potential donors during protective intensive care. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. 2025;23(4):347-352. (In Russ.). doi: http://dx.doi.org/10.25298/2221-8785-2025-23-4-347-352
9. Becker KL, Snider R, Nylen ES. Procalcitonin assay in systemic inflammation, infection, and sepsis: clinical utility and limitations. Critical Care Medicine. 2008 Mar;36(3):941-952. doi: http://dx.doi.org/10.1097/CCM.0B013E318165BABB
10. Rangeard O, Audibert G, Perrier JF, Loos-Ayav C, Lalot J-M, Agavriloaie M, et al. Relationship between procalcitonin values and infection in brain-dead organ donors. Transplantation proceedings. 2007 Dec;39(10):2970-2974. doi: http://dx.doi.org/10.1016/j.transproceed.2007.02.101
11. EnglbrechtJS, Bracht H, Gehrenkemper JP, Borgstedt R, Witzke D, Gottschalk A, et al. Anti-infective management in brain-dead organ donors - a retrospective analysis at two centers reveals need for improvement. Journal of Critical Care. 2025 Dec;90:155196. doi: http://dx.doi.org/10.1016/j.jcrc.2025.155196
12. Wagner FD, Jonitz B, Potapov EV, Qedra N, Wegscheider K, Abraham K, et al. Procalcitonin, a donor-specific predictor of early graft failure-related mortality after heart transplantation. Circulation. 2001 Sep;104(12 Suppl 1):I192-196. doi: http://dx.doi.org/10.1161/hc37t1.094836
13. Eyraud D, Ben Ayed S, Tanguy ML, Vézinet C, Siksik JM, Bernard M, et al. Procalcitonin in liver transplantation: are high levels due to donors or recipients? Critical care. 2008;12(4):R85. doi: http://dx.doi.org/10.1186/cc6942
Submitted 27.02.2026
Accepted 19.06.2026
Information about authors:
Artur L. Lipnitski – Candidate of Medical Sciences, Head of the department for coordination of taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-2556-4801, e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра.;
A.V. Marochkov – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the branch of the Chairs of Anesthesiology & Resuscitation and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-5092-8315
