Systemic liberation of interleukin-1? and interleukin-1 receptor antagonist in the perioperative phase of liver transplantation

Gerlach, Jörg C.; Jörres, Achim; Berger, Axel; Schön, Michael P.; Smith, Mark D.; Nohr, Roland; Neuhaus, P.

doi:10.1007/bf00335704

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…30 Another explanation for this finding might be that peak IL-1␤ levels were related to duration of cold ischemia time and IL-1␤ levels in donor plasma, in contrast to other cytokines. A previous study 31 also showed greater IL-1␤ levels after long cold ischemia times, but in contrast to that report, we found a significant increase in IL-1␤ concentrations in all our patients.…”

Section: Discussioncontrasting

confidence: 99%

Endotoxins and Cytokines During Liver Transplantation: Changes in Plasma Levels and Effects on Clinical Outcome

Maring

Klompmaker

Zwaveling

et al. 2000

Liver Transplantation

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Endotoxins, tumor necrosis factor-␣ (TNF-␣), 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-␣ was released from the graft after reperfusion, and initial levels after reperfusion were related to predonation levels in the donor. Only levels of TNF-␣ 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. (Liver Transpl 2000;6:480-488.) L iver transplantation is standard treatment for patients with end-stage liver disease. Although improvements over the years have increased survival, initial liver function is not optimal in all cases, 1 and infection and rejection are common. Research has focused on graft preservation and reperfusion injury 2 as causative factors for these events. Reperfusion injury is characterized by a loss of endothelial cell viability associated with Kupffer cell activation. 3 Proinflammatory cytokines, especially tumor necrosis factor-␣ (TNF-␣), 4 are presumed to have a key role in this process. Elevated levels of cytokines have been reported after liver transplantation, as well as after other types of surgery. 5 The exact dynamics in cytokine concentrations are not clear. [6][7][8] Several factors may influence levels of cytokines, such as the presence of endotoxins during the liver transplantation procedure, 9 ischemia, and manipulation of other organs during transplantation, especially the splanchnic viscera. 10 Postreperfusion systemic levels of cytokines in the transplant recipient may be influenced by their serum levels in the donor. 11 Finally, preoperative systemic levels of cytokines in the transplant recipient might be an important factor because they are related to the nature and stage of the underlying disease. 12,13 The role of cytokines in human liver transplantation remains controversial. 6,14 There is some evidence that cytokines are involved in rejection and infection in the early postoperative phase, but available data are not consistent.We performed this study to evaluate changes in cytokine levels during and shortly after orthotopic liver transplantation and to assess their relation to clinical outcome. Patients and MethodsThe study was approved by the institutional review board of our hospital, and informed consent was obtained from each participating patient or a relative, in case of coma. Liver TransplantationDonor livers were not accepted when the donor was aged older than 65 years; had a history of liver disease, alcoholis...

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Section: Discussioncontrasting

confidence: 99%

Endotoxins and Cytokines During Liver Transplantation: Changes in Plasma Levels and Effects on Clinical Outcome

Maring

Klompmaker

Zwaveling

et al. 2000

Liver Transplantation

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“…In response to injury, trauma, or infection, cytokines play an important role in the acute phase. The proinflammatory cytokines IL-1, IL-6, and TNFa participate in a synergetic manner to mediate inflammation in this acute phase response [3].…”

Section: Introductionmentioning

confidence: 99%

Heparin coating reduces cell activation and mediator release in an in vitro venovenous bypass model for liver transplantation

Solberg¹,

Scholz²,

Videm³

et al. 1998

Transplant Int

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We used an in vitro model for venovenous bypass in a prospective, randomized study to analyze the effect on leukocytes cell activation after coating the total blood contact surface with covalently bound heparin. In ten experiments heparin-coated circuits were used, and in ten other experiments noncoated circuits were used. Monocyte cytokine production and neutrophil myeloperoxidase release were analyzed. Monocytes were isolated using anti-CD14 paramagnetic beads, and oligo(dT),, beads were used to isolate mRNA before subsequent reverse transcription and semiquantitative amplification of various cytokines in order to determine timerelated changes in expression during bypass. After 2 h, mRNAs for IL-1P and IL-6 were highly upregulated in noncoated compared to heparincoated circuits. Little or no change was seen in the expression of other cytokines. IL-lP and IL-6 were measured in plasma after 12 h and reflected the upregulated mRNAs in noncoated circuits. A significantly reduced release of myeloperoxidase was observed in coated versus noncoated circuits. This indicates that heparin-coated surfaces reduce cellular activation and the release of inflammatory mediators.

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Systemic liberation of interleukin-1? and interleukin-1 receptor antagonist in the perioperative phase of liver transplantation

Cited by 2 publications

References 43 publications

Endotoxins and Cytokines During Liver Transplantation: Changes in Plasma Levels and Effects on Clinical Outcome

Endotoxins and Cytokines During Liver Transplantation: Changes in Plasma Levels and Effects on Clinical Outcome

Heparin coating reduces cell activation and mediator release in an in vitro venovenous bypass model for liver transplantation

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