Tange S, Höfer Y, Welte M, Anthuber M, Jauch K W, Geissler E K, Ertel W
Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93055 Regensburg, Germany.
Transpl Int. 2001;14(2):80-6. doi: 10.1007/s001470050851.
Hepatic ischemia/reperfusion leads to an excessive release of proinflammatory cytokines, which promotes local and remote cell damage. The value of cytokine measurement in humans for predicting graft function after orthotopic liver transplantation (OLT) remains unclear. Therefore, in this study, tumor-necrosis-factor-alpha (TNF-alpha), interleukin-6 (IL-6), and endotoxin (ET) levels were determined in the blood taken from the hepatic veins of 31 patients who underwent OLT. Peak levels of TNF-alpha in hepatic venous blood were measured shortly after reperfusion and were significantly higher than concentrations in the systemic circulation. IL-6 concentrations, peaking 90 min after reperfusion, only correlated with postoperative pulmonary dysfunction. ET was detectable in 21 patients, but levels did not correlate with either IL-6 or TNF-alpha concentrations. Additionally, serum cytokine levels did not correlate with the duration of ischemia or with histological changes seen in liver biopsies. In general, our study suggests that local secretion of cytokines does not predict liver function in the early posttransplant phase.
肝脏缺血/再灌注会导致促炎细胞因子过度释放，从而促进局部和远处的细胞损伤。细胞因子检测在预测人类原位肝移植（OLT）后移植物功能方面的价值仍不明确。因此，在本研究中，我们测定了31例行OLT患者肝静脉血中肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和内毒素（ET）的水平。再灌注后不久测定肝静脉血中TNF-α的峰值水平，其显著高于体循环中的浓度。IL-6浓度在再灌注后90分钟达到峰值，仅与术后肺功能障碍相关。21例患者可检测到ET，但ET水平与IL-6或TNF-α浓度均无相关性。此外，血清细胞因子水平与缺血持续时间或肝活检中的组织学变化均无相关性。总体而言，我们的研究表明，细胞因子的局部分泌并不能预测移植后早期的肝功能。
