Soluble intercellular adhesion molecule (ICAM)-1 detects invasive fungal infections in patients following liver transplantation

Biomarkers. 2020 Nov;25(7):548-555. doi: 10.1080/1354750X.2020.1810318. Epub 2020 Aug 28.


Purpose: Despite antifungal prophylaxis, liver transplanted patients are endangered by invasive fungal infections (IFI). Routinely used microbiological procedures are hallmarked by significant weaknesses, which may lead to a delay in antifungal treatment.

Methods: Culture-based fungal findings, routinely used biomarkers of infection/inflammation (e.g., procalcitonin or C-reactive protein), as well as corresponding plasma concentrations of soluble Intercellular Adhesion Molecule (ICAM)-1 were analysed in 93 patients during a period of 28 days following liver transplantation (LTX).

Results: Plasmatic sICAM-1 was significantly elevated in patients affected by an IFI within the first 28 days in comparison to fungally colonised or unobtrusive LTX patients. sICAM-1 might therefore be helpful for the identification of IFI patients after LTX (e.g., Receiver Operating Characteristic (ROC)-Area Under the Curve (AUC): 0.714 at 14d after LTX). The diagnostic performance of sICAM-1 was further improved by its combined use with different other IFI biomarkers (e.g., midregional proadrenomedullin).

Conclusion: The diagnostic deficiencies of routinely used microbiological procedures for IFI detection in patients after LTX may be reduced by plasmatic sICAM-1 measurements. Clinical Trial Notation. German Clinical Trials Register: DRKS00005480.

Keywords: Aspergillus spp.; Candida spp.; fungal colonisation; invasive fungal infection; liver transplantation; soluble intercellular adhesion molecule-1.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Biomarkers / blood*
  • C-Reactive Protein / genetics
  • Female
  • Humans
  • Intercellular Adhesion Molecule-1 / blood
  • Intercellular Adhesion Molecule-1 / genetics*
  • Invasive Fungal Infections / blood*
  • Invasive Fungal Infections / complications
  • Invasive Fungal Infections / microbiology
  • Invasive Fungal Infections / pathology
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Risk Factors


  • Antifungal Agents
  • Biomarkers
  • ICAM1 protein, human
  • Intercellular Adhesion Molecule-1
  • C-Reactive Protein