Baron-Stefaniak Joanna, Schiefer Judith, Miller Edmund J, Plöchl Walter, Krenn Claus G, Berlakovich Gabriela A, Baron David M, Faybik Peter
Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Vienna, Austria.
Heart and Lung Research Center, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
Clin Transplant. 2017 Jun;31(6). doi: 10.1111/ctr.12982. Epub 2017 Apr 21.
Experimental studies suggest that macrophage migration inhibitory factor (MIF) mediates ischemia/reperfusion injury during liver transplantation. This study assessed whether human liver grafts release MIF during preservation, and whether the release of MIF is proportional to the extent of hepatocellular injury. Additionally, the association between MIF and early allograft dysfunction (EAD) after liver transplantation was evaluated. Concentrations of MIF, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) were measured in effluents of 38 liver grafts, and in serum of recipients. Concentrations of MIF in the effluent were greater than those in the recipients' serum before and after reperfusion (58 [interquartile range, IQR:23-79] μg/mL vs 0.06 [IQR:0.03-0.07] μg/mL and 1.3 [IQR:0.7-1.8] μg/mL, respectively; both P<.001). Effluent MIF concentrations correlated with effluent concentrations of the cell injury markers ALT (R=.51, P<.01), AST (R=.51, P<.01), CK (R=.45, P=.01), and LDH (R=.56, P<.01). Patients who developed EAD had greater MIF concentrations in effluent and serum 10 minutes after reperfusion than patients without EAD (Effluent: 80 [IQR:63-118] μg/mL vs 36 [IQR:20-70] μg/mL, P=.02; Serum: 1.7 [IQR:1.2-2.5] μg/mL vs 1.1 [IQR:0.6-1.7] μg/mL, P<.001).
Human liver grafts release MIF in proportion to hepatocellular injury. Greater MIF concentrations in effluent and recipient's serum are associated with EAD after liver transplantation.
实验研究表明，巨噬细胞移动抑制因子（MIF）介导肝移植期间的缺血/再灌注损伤。本研究评估了人肝移植物在保存期间是否释放MIF，以及MIF的释放是否与肝细胞损伤程度成正比。此外，还评估了MIF与肝移植后早期移植物功能障碍（EAD）之间的关联。测量了38例肝移植物流出液及受者血清中MIF、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、乳酸脱氢酶（LDH）和肌酸激酶（CK）的浓度。再灌注前后，流出液中MIF的浓度均高于受者血清中的浓度（分别为58[四分位数间距，IQR：23 - 79]μg/mL vs 0.06[IQR：0.03 - 0.07]μg/mL和1.3[IQR：0.7 - 1.8]μg/mL；P均<0.001）。流出液中MIF浓度与细胞损伤标志物ALT（R = 0.51，P < 0.01）、AST（R = 0.51，P < 0.01）、CK（R = 0.45，P = 0.01）和LDH（R = 0.56，P < 0.01）的流出液浓度相关。发生EAD的患者再灌注10分钟后流出液和血清中的MIF浓度高于未发生EAD的患者（流出液：80[IQR：63 - 118]μg/mL vs 36[IQR：20 - 70]μg/mL，P = 0.02；血清：1.7[IQR：1.2 - 2.5]μg/mL vs 1.1[IQR：0.6 - 1.7]μg/mL，P < 0.001）。
人肝移植物释放MIF的量与肝细胞损伤程度成正比。流出液和受者血清中较高的MIF浓度与肝移植后的EAD相关。
