Transhepatic neutrophil and monocyte activation during clinical liver transplantation.
BACKGROUND
During experimental liver transplantation, neutrophil sequestration results in increased oxygen free radical production and correlates inversely with graft viability. Neutrophil activation in clinical liver transplantation is poorly understood.


METHODS
We assessed leukocyte sequestration and transhepatic differences of neutrophil and monocyte CD11b expression, neutrophil free radical production, and plasma concentrations of interleukin 6 and interleukin 8 in nine patients during liver transplantation.


RESULTS
Significant hepatic neutrophil sequestration occurred during initial graft rewarming with portal blood, after inferior vena cava declamping, and after hepatic artery declamping (all P<0.05). A positive transhepatic difference (i.e., outcoming - ingoing) in CD11b expression of neutrophils was observed after portal vein declamping (51+/-32 relative fluorescence unit [RFU]) and in CD11b expression of monocytes during initial graft rewarming (67+/-86 RFU, both P<0.05). A transcoronary increase in both unstimulated (74+/-80 RFU) and N-formyl-methionyl-leucylphenylalanine-stimulated (112+/-168 RFU) neutrophil free radical production took place after hepatic artery declamping (both P<0.05). A negative transcoronary difference of interleukin 6 occurred during initial graft rewarming (-192+/-176 pg/ml) and a positive difference of interleukin 8 occurred after hepatic artery declamping (17+/-23 pg/ml, both P<0.05).


CONCLUSIONS
Hepatic sequestration and transhepatic activation of neutrophils, and hepatic production of interleukin 8 occur during clinical liver transplantation. A splanchnic influx of interleukin 6 occurs to the graft, possibly modulating neutrophil-mediated graft reperfusion injury.
Pesonen
E J
EJ
Department of Anesthesia and Intensive Care Medicine, Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland. epesonen@helsinki.fi
Höckerstedt
K
K
Mäkisalo
H
H
Vuorte
J
J
Jansson
S E
SE
Orpana
A
A
Karonen
S L
SL
Repo
H
H
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007425:Intracellular Membranes / Q000378:metabolism; D007432:Intraoperative Period; D007958:Leukocyte Count; D008107:Liver Diseases / Q000097:blood / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D016177:Macrophage-1 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000473:pathology / Q000502:physiology*; D009504:Neutrophils / Q000276:immunology / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D016896:Treatment Outcome
D015850:Interleukin-6; D016209:Interleukin-8; D016177:Macrophage-1 Antigen; D006861:Hydrogen Peroxide