Predictive Role of Serum Cytokine Profiles in Acute Kidney Injury after Living Donor Liver Transplantation

Abstract

Introduction Previous studies have shown that a higher serum interleukin- (IL-) 6 level is associated with a higher risk of acute kidney injury (AKI) development after major nontransplant surgery. Our study investigated the potential association of preoperative serum cytokine profiles with new AKI development in patients who underwent living donor liver transplantation (LDLT). Methods Serum levels of cytokines IL-2, IL-6, IL-10, IL-12, and IL-17, interferon-γ, and tumor necrosis factor- (TNF-) α were measured in 226 LDLT recipients preoperatively and analyzed retrospectively. Recipients with a preoperative functional impairment of the kidney were excluded. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results In a univariate regression model, IL-6, IL-17, and TNF-α levels showed an association with AKI development after LDLT. Multivariate analysis showed an independent association of the preoperative serum IL-6 level with AKI development after LDLT and a significant relationship between higher serum IL-6 levels and a greater likelihood of developing AKI. Serum IL-6 levels were higher in patients with stage 3 AKI than in patients who did not develop AKI. Conclusions Our results support the need for further investigations of IL-6 as a predictor of AKI development in patients undergoing LDLT.

Sequential Use of Normothermic Regional and Ex Situ Machine Perfusion in Donation After Circulatory Death Liver Transplant

“…( 41,42 ) Consistently, IL6 overproduction, as shown during DHOPE, has been associated with a higher risk of AKI development. ( 43 ) Interestingly, IL10, which is involved in the reduction of IRI inflammation associated injury, ( 44 ) is equally produced by NMP and DHOPE.…”

Low Preoperative Antithrombin III level is Associated with Postoperative Acute Kidney Injury after Liver Transplantation

“…Several perioperative factors, such as a high model for end-stage liver disease (MELD) scores, pre-LT renal dysfunction, graft quality, and intraoperative hemodynamic instability, are reported to be associated with post-LT AKI [2,4,5]. In recent times, in ammation has been considered to be the potential mechanism in the development of AKI [6,7].…”

“…In addition, systemic in ammatory reaction and the associated immunological imbalance are believed to form the combined pathophysiological pathway of ESLD [6]. Moreover, the role of in ammation has been receiving increasing focus as a key factor for postoperative AKI [7,14,15].…”

“…Furthermore, AKI can progress into chronic kidney injury [3].Several perioperative factors, such as a high model for end-stage liver disease (MELD) scores, pre-LT renal dysfunction, graft quality, and intraoperative hemodynamic instability, are reported to be associated with post-LT AKI [2,4,5]. In recent times, in ammation has been considered to be the potential mechanism in the development of AKI [6,7].Antithrombin III (ATIII), produced by the liver, has both anti-coagulative and anti-in ammatory effects [8].Previous studies regarding LT surgery focused only on the effect of ATIII as a serine protease inhibitor in the coagulation cascade to prevent hepatic artery thrombosis or portal vein thrombosis [9,10]. The renoprotective potential of ATIII has been consistently supported by evidences from numerous animal studies [11,12].…”

Predictive role of vitamin B12 in acute kidney injury in living donor liver transplantation: a propensity score matching analysis

“…5 In addition, proinflammatory markers such as interleukin (IL)-6 are associated with AKI after LDLT. 6 Many studies have reported that AKI negatively affects postoperative outcomes, resulting in a prolonged hospital stay, early graft dysfunction, infection and poor patient survival. 7 8 Therefore,…”