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  • Title: [Alteration in serum cytokines of patients with multiple organ dysfunction syndrome after liver transplantation].
    Author: Shen ZY, Liu YH, Wang Y, Liu L, Ming Y.
    Journal: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue; 2007 Jan; 19(1):28-30. PubMed ID: 17207361.
    Abstract:
    OBJECTIVE: To explore the serum cytokine fluctuation in those adult patients with multiple organ dysfunction syndrome (MODS) during the post-operation stage of orthotopic liver transplantation (OLT) to guide the clinical treatment. METHODS: Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-8 and IL-10 were determined in 53 MODS patients who had received OLT. They were divided into two groups as control group and experimental group, according to whether continuous blood purification (CBP) had been performed or not. The levels of serum cytokines and intensive care unit (ICU) stay time, intubation time, mortality and ICU expenses were compared between the two groups. RESULTS: The levels of serum TNF-alpha, IL-6 and IL-8 rose, while that of IL-10 increased dramatically compared with normal values (all P<0.05). After CBP, the serum levels of TNF-alpha, IL-6 and IL-8 all dropped to certain extent and became lower than those before the treatment (all P<0.05). IL-10's serum level was not changed compared with that before treatment. Those who received CBP stayed in the ICU for a longer period compared with control group, and the ICU expenses increased evidently with significant differences (P<0.05 or P<0.01). However, there was no difference in mortality between the two groups. CONCLUSION: Under the effect of immunosuppressant in the post-OLT period, the excessive release of the anti-inflammatory mediators may become dominant leading to imbalance between proinflammatory and anti-inflammatory mediators leading to MODS. CBP may remove serum proinflammatory cytokines to act as an effective supportive treatment.
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