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  • Title: Plasma levels of tumor necrotic factor-alpha and interleukin-6, -8 during orthotopic liver transplantation and their relations to postoperative pulmonary complications.
    Author: Wen XH, Kong HY, Zhu SM, Xu JH, Huang SQ, Chen QL.
    Journal: Hepatobiliary Pancreat Dis Int; 2004 Feb; 3(1):38-41. PubMed ID: 14969835.
    Abstract:
    BACKGROUND: Pulmonary complications after orthotopic liver transplantation (OLT) include high morbidity and mortality. Experimental data have suggested hepatic ischemia and reperfusion are induced by pro-inflammatory cytokines. The high level of inflammatory cytokines might additionally influence pulmonary capillary fluid filtration. The objectives of this study were to measure the concentrations of tumor necrotic factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-8 (IL-8) during OLT and to investigate the relationship between these cytokines and postoperative pulmonary complications. METHODS: Twenty-two patients undergoing OLT were divided into two groups according to whether they had postoperative pulmonary complications: group A consisting of 8 patients with postoperative pulmonary complications, and group B consisting of 14 patients without postoperative pulmonary complications. Enzyme-linked immunoassay (ELISA) was used to determine serum TNF-alpha, IL-6 and IL-8. Blood samples were taken at the beginning of operation (T0), clamping and cross-clamping of the inferior cava and portal vein (T1, T2), 90 minutes and 3 hours after reperfusion (T3, T4) and 24 hours after operation (T5). RESULTS: The level of PaO2/FiO2 in group A was lower than that in group B (P<0.05). The concentrations of TNF-alpha, IL-6 and IL-8 in the two groups increased rapidly at T2, peaked at T3, decreased rapidly after T3 until 24 hours after operation. The concentrations of TNF-alpha, IL-6 and IL-8 in group A were higher than those in group B at T2, T3, and T4 (P<0.05). CONCLUSION: After un-clamping of the inferior cava and portal vein, the serum concentrations of TNF-alpha, IL-6 and IL-8 increased may be related to pulmonary injury after hepatic ischemic reperfusion.
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