Monocytic Human Leukocyte Antigen-DR Expression for Prediction of Anastomotic Leak after Colorectal Surgery

ABSTRACT Background Earlier detection of anastomotic leakage (AL) following colorectal surgery could minimize the detrimental clinical impact of AL and thereby reduce morbidity and mortality. Study Design Prospective study with assessment of the diagnostic accuracy of monocytic human leukocyte antigen-DR (mHLA-DR) expression compared to white blood cells (WBC), C-reactive protein (CRP), and procalcitonin (PCT) in predicting AL in patients undergoing elective colorectal surgery with anastomosis. Results Comparison of the blood marker values on postoperative day 4 revealed significant differences for all markers, whereat the difference for mHLA-DR was highly significant (15% expression of monocytes in AL patients vs. 34% in patients without AL; P=0.001). Together with WBC (P=0.026), mHLA-DR expression was the only test to show significance on day 3 (14% vs 31%; P Conclusions Expression of mHLA-DR appears to be a more accurate predictor for AL following colorectal surgery compared to WBC, CRP and PCT. It represents a promising test to precisely monitor the perioperative course of high-risk patients and contribute to safer discharge.