Interleukin-6, a marker of preservation injury in clinical lung transplantation.
Interleukin-6 (IL-6) is one of the cytokines produced by human alveolar macrophages, lung parenchyma, and other cells in response to injury and infection. We hypothesized that IL-6 is released from poorly preserved lung grafts and may serve as a marker of preservation injury. Sixteen patients who received lung allografts were enrolled in this study. The average ischemic time was 284 +/- 78 minutes. Serum IL-6 level was measured before and at 4 and 24 hours after reperfusion of the grafts by an enzyme-linked immunosorbent assay. Preservation injury was assessed by (1) the need for prolonged intubation (> 7 days), (2) the arterial/alveolar oxygen tension ratio (PaO2/PAO2 ratio) at 4 hours after graft reperfusion (only in heart-lung or double lung recipients), (3) the presence of diffuse alveolar damage on first lung biopsy, and (4) the 30-day graft survival rate. IL-6 level peaked at 4 hours after reperfusion and returned to baseline at 24 hours. The patients were divided into group I (n = 6) and group II (n = 10), depending on whether the 4-hour IL-6 level was more than 1000 pg/ml or less than 500 pg/ml, respectively. Group I patients required longer intubation (p < 0.01) and had a lower PaO2/PAO2 ratio (p < 0.001), more diffuse alveolar damage (p < 0.01), and a lower graft survival rate (p < 0.01) than those of group II. No bacterial, fungal, or viral infection was found during postoperative week 1 in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
Pham
S M
SM
Department of Surgery, University of Pittsburgh School of Medicine, Pa. 15261.
Yoshida
Y
Y
Aeba
R
R
Hattler
B G
BG
Iwaki
Y
Y
Zeevi
A
A
Hardesty
R L
RL
Griffith
B P
BP
D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006085:Graft Survival; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007442:Intubation, Intratracheal; D008168:Lung / Q000473:pathology*; D016040:Lung Transplantation / Q000276:immunology* / Q000473:pathology; D008297:Male; D009926:Organ Preservation / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D015850:Interleukin-6