Early release of proinflammatory cytokines after lung transplantation.
BACKGROUND
Systemic hypotension may complicate the early postoperative period after lung transplantation. A release of proinflammatory cytokines secondary to lung ischemia/reperfusion injury could be involved in the pathogenesis of this early hemodynamic failure (EHF).


OBJECTIVE
To assess prospectively whether the occurrence of EHF is associated with a release of cytokines in the systemic circulation.


METHODS
Blood samples were taken daily during the first postoperative week in 26 patients who underwent a double or a single-lung transplantation. These patients were divided into three groups: 7 patients who experienced EHF and subsequently died (EHF group); 15 patients without EHF (control group); and 4 patients without EHF but with an identified sepsis (sepsis group). The serum levels of interleukin (IL)-1beta, tumor necrosis factor-alpha (TNF-alpha), IL-6, and IL-8 were compared among the three groups.


RESULTS
In the EHF group, the levels of each cytokine peaked at day 1 postoperatively. Cytokine levels at day 1 were significantly higher in the EHF group than in the control group (p<0.0006) or in the sepsis group (p<0.003 except for TNF-alpha).


CONCLUSIONS
We conclude that EHF is associated with a massive release of proinflammatory cytokines that could play a determinant role in the pathogenesis of this complication.
Mal
H
H
Service de Pneumologie et Réanimation Respiratoire, Hôpital Beaujon, Clichy, France.
Dehoux
M
M
Sleiman
C
C
Boczkowski
J
J
Lesèche
G
G
Pariente
R
R
Fournier
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D006439:Hemodynamics; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D016040:Lung Transplantation; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000097:blood / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D011652:Pulmonary Circulation; D015427:Reperfusion Injury / Q000097:blood / Q000503:physiopathology; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D018836:Inflammation Mediators; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha