Release of cytokines and hemodynamic instability during the reperfusion of a liver graft

Dmitri Bezinover, Zakiyah Kadry, Paul McCullough, Patrick McQuillan, Todahiro Uemura, Kelli Welker, Andrea Marie Mastro, Piotr Janicki

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The objectives of this prospective, observational study were (1) to determine whether a transplanted liver graft releases proinflammatory cytokines into the systemic circulation upon reperfusion and (2) to determine whether they contribute to any subsequent hemodynamic instability observed after graft reperfusion (if this release occurs). Blood samples from 17 consecutive patients undergoing liver transplantation were analyzed for cytokines, including tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-2, IL-6, and IL-8. Blood samples were obtained from the radial artery, portal vein, and flush blood (a sample taken from a catheter placed above the infrahepatic inferior vena cava clamp). The amount of catecholamines necessary to maintain a mean arterial pressure between 65 and 75 mm Hg during graft reperfusion was compared with the level of cytokines. A statistical analysis was performed with the least squares method, Kendall's tau-b test, and regression analysis. We demonstrated that flush blood from the liver grafts contained a significant amount and variety of cytokines. Most of these were removed by graft irrigation. The concentration of TNF-α in samples obtained from flush blood at the end of liver irrigation was significantly higher than the concentration in samples obtained from the radial artery (P = 0.0067) or portal vein (P = 0.0003) before reperfusion. This correlated directly with the amount of catecholamines used to treat hemodynamic instability. Although there were increased levels of IL-1β, IL-2, and IL-8 in the flush blood, there was no statistically significant correlation between the levels of these cytokines and the amount of catecholamines used.

Original languageEnglish (US)
Pages (from-to)324-330
Number of pages7
JournalLiver Transplantation
Volume17
Issue number3
DOIs
StatePublished - Mar 1 2011

Fingerprint

Reperfusion
Hemodynamics
Cytokines
Transplants
Liver
Catecholamines
Radial Artery
Portal Vein
Interleukin-8
Interleukin-1
Interleukin-2
Tumor Necrosis Factor-alpha
Inferior Vena Cava
Least-Squares Analysis
Liver Transplantation
Observational Studies
Interleukin-6
Arterial Pressure
Catheters
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Bezinover, Dmitri ; Kadry, Zakiyah ; McCullough, Paul ; McQuillan, Patrick ; Uemura, Todahiro ; Welker, Kelli ; Mastro, Andrea Marie ; Janicki, Piotr. / Release of cytokines and hemodynamic instability during the reperfusion of a liver graft. In: Liver Transplantation. 2011 ; Vol. 17, No. 3. pp. 324-330.
@article{ae09e6bbed9b4ec8903153448a6df7f6,
title = "Release of cytokines and hemodynamic instability during the reperfusion of a liver graft",
abstract = "The objectives of this prospective, observational study were (1) to determine whether a transplanted liver graft releases proinflammatory cytokines into the systemic circulation upon reperfusion and (2) to determine whether they contribute to any subsequent hemodynamic instability observed after graft reperfusion (if this release occurs). Blood samples from 17 consecutive patients undergoing liver transplantation were analyzed for cytokines, including tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-2, IL-6, and IL-8. Blood samples were obtained from the radial artery, portal vein, and flush blood (a sample taken from a catheter placed above the infrahepatic inferior vena cava clamp). The amount of catecholamines necessary to maintain a mean arterial pressure between 65 and 75 mm Hg during graft reperfusion was compared with the level of cytokines. A statistical analysis was performed with the least squares method, Kendall's tau-b test, and regression analysis. We demonstrated that flush blood from the liver grafts contained a significant amount and variety of cytokines. Most of these were removed by graft irrigation. The concentration of TNF-α in samples obtained from flush blood at the end of liver irrigation was significantly higher than the concentration in samples obtained from the radial artery (P = 0.0067) or portal vein (P = 0.0003) before reperfusion. This correlated directly with the amount of catecholamines used to treat hemodynamic instability. Although there were increased levels of IL-1β, IL-2, and IL-8 in the flush blood, there was no statistically significant correlation between the levels of these cytokines and the amount of catecholamines used.",
author = "Dmitri Bezinover and Zakiyah Kadry and Paul McCullough and Patrick McQuillan and Todahiro Uemura and Kelli Welker and Mastro, {Andrea Marie} and Piotr Janicki",
year = "2011",
month = "3",
day = "1",
doi = "10.1002/lt.22227",
language = "English (US)",
volume = "17",
pages = "324--330",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "3",

}

Release of cytokines and hemodynamic instability during the reperfusion of a liver graft. / Bezinover, Dmitri; Kadry, Zakiyah; McCullough, Paul; McQuillan, Patrick; Uemura, Todahiro; Welker, Kelli; Mastro, Andrea Marie; Janicki, Piotr.

In: Liver Transplantation, Vol. 17, No. 3, 01.03.2011, p. 324-330.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Release of cytokines and hemodynamic instability during the reperfusion of a liver graft

AU - Bezinover, Dmitri

AU - Kadry, Zakiyah

AU - McCullough, Paul

AU - McQuillan, Patrick

AU - Uemura, Todahiro

AU - Welker, Kelli

AU - Mastro, Andrea Marie

AU - Janicki, Piotr

PY - 2011/3/1

Y1 - 2011/3/1

N2 - The objectives of this prospective, observational study were (1) to determine whether a transplanted liver graft releases proinflammatory cytokines into the systemic circulation upon reperfusion and (2) to determine whether they contribute to any subsequent hemodynamic instability observed after graft reperfusion (if this release occurs). Blood samples from 17 consecutive patients undergoing liver transplantation were analyzed for cytokines, including tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-2, IL-6, and IL-8. Blood samples were obtained from the radial artery, portal vein, and flush blood (a sample taken from a catheter placed above the infrahepatic inferior vena cava clamp). The amount of catecholamines necessary to maintain a mean arterial pressure between 65 and 75 mm Hg during graft reperfusion was compared with the level of cytokines. A statistical analysis was performed with the least squares method, Kendall's tau-b test, and regression analysis. We demonstrated that flush blood from the liver grafts contained a significant amount and variety of cytokines. Most of these were removed by graft irrigation. The concentration of TNF-α in samples obtained from flush blood at the end of liver irrigation was significantly higher than the concentration in samples obtained from the radial artery (P = 0.0067) or portal vein (P = 0.0003) before reperfusion. This correlated directly with the amount of catecholamines used to treat hemodynamic instability. Although there were increased levels of IL-1β, IL-2, and IL-8 in the flush blood, there was no statistically significant correlation between the levels of these cytokines and the amount of catecholamines used.

AB - The objectives of this prospective, observational study were (1) to determine whether a transplanted liver graft releases proinflammatory cytokines into the systemic circulation upon reperfusion and (2) to determine whether they contribute to any subsequent hemodynamic instability observed after graft reperfusion (if this release occurs). Blood samples from 17 consecutive patients undergoing liver transplantation were analyzed for cytokines, including tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), IL-2, IL-6, and IL-8. Blood samples were obtained from the radial artery, portal vein, and flush blood (a sample taken from a catheter placed above the infrahepatic inferior vena cava clamp). The amount of catecholamines necessary to maintain a mean arterial pressure between 65 and 75 mm Hg during graft reperfusion was compared with the level of cytokines. A statistical analysis was performed with the least squares method, Kendall's tau-b test, and regression analysis. We demonstrated that flush blood from the liver grafts contained a significant amount and variety of cytokines. Most of these were removed by graft irrigation. The concentration of TNF-α in samples obtained from flush blood at the end of liver irrigation was significantly higher than the concentration in samples obtained from the radial artery (P = 0.0067) or portal vein (P = 0.0003) before reperfusion. This correlated directly with the amount of catecholamines used to treat hemodynamic instability. Although there were increased levels of IL-1β, IL-2, and IL-8 in the flush blood, there was no statistically significant correlation between the levels of these cytokines and the amount of catecholamines used.

UR - http://www.scopus.com/inward/record.url?scp=79952429282&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952429282&partnerID=8YFLogxK

U2 - 10.1002/lt.22227

DO - 10.1002/lt.22227

M3 - Article

C2 - 21384515

AN - SCOPUS:79952429282

VL - 17

SP - 324

EP - 330

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 3

ER -