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Endotoxins and cytokines during liver transplantation: Changes in plasma levels and effects on clinical outcome
Author(s) -
Maring John K.,
Klompmaker Ids J.,
Zwaveling Jan H.,
van der Meer Jan,
Limburg Pieter C.,
Slooff Maarten J.H.
Publication year - 2000
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2000.8311
Subject(s) - medicine , liver transplantation , tumor necrosis factor alpha , transplantation , prospective cohort study , cytokine , reperfusion injury , interleukin , outcome (game theory) , gastroenterology , tumor necrosis factor α , ischemia , immunology , mathematics , mathematical economics
Endotoxins, tumor necrosis factor‐α (TNF‐α), interleukin‐1 (IL‐1), and IL‐6 are believed to have a key role in liver transplantation. The origin and course of these factors is not completely known. In this prospective study of 40 patients, we sought more understanding of the relations between these factors and their effects on clinical outcome by sampling at different sites. Endotoxemia was only present in 20% of the patients. In 75% of these patients, it was present during the anhepatic phase and quickly resolved after reperfusion. Endotoxemia was not related to a clinical adverse event. TNF‐α was released from the graft after reperfusion, and initial levels after reperfusion were related to predonation levels in the donor. Only levels of TNF‐α in the recipient before transplantation were found to be predictive of postoperative complications. We conclude that monitoring endotoxins and these cytokines is of very limited value in predicting outcome.