Tumour necrosis factor-alpha and interleukin-6: early indicators of bacterial infection after human orthotopic liver transplantation.
OBJECTIVE
To see if it was possible to predict the development of infection after liver transplantation from concentrations of endotoxin, tumour necrosis factor-alpha (TNF-alpha), or interleukin-6 (IL-6) in plasma.


METHODS
Prospective open study.


METHODS
University hospital, Austria.


METHODS
46 Consecutive patients who underwent liver transplantation for end stage liver disease, 1989-90.


METHODS
Samples of 4 ml blood were taken in endotoxin free tubes, and of 10 ml into heparinised tubes at the beginning of the operation, during hepatectomy, at the beginning and end of the anhepatic phase, 10 minutes after reperfusion, and at the end of the operation.


METHODS
Correlation between development of infections postoperatively and operative release of endotoxin, TNF-alpha, and IL-6.


RESULTS
There was no correlation between development of postoperative infections and operative concentrations of endotoxin, and of TNF-alpha and IL-6 up to the end of the anhepatic phase. There was, however, a sixfold increase in TNF-alpha and IL-6 concentrations between the end of the anhepatic phase and the end of the operation in patients who subsequently developed infections (p = 0.01).


CONCLUSIONS
The increase in the concentrations of these two cytokines in the blood after reperfusion of the transplanted liver seems to predict the development of subsequent bacterial infection.
Sautner
T
T
Division of General Surgery, University of Vienna, Austria.
Függer
R
R
Götzinger
P
P
Mittlböck
M
M
Winkler
S
S
Roth
E
E
Steininger
R
R
Mühlbacher
F
F
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D005260:Female; D006801:Humans; D015850:Interleukin-6; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha