title: Cytokine profile after lung transplantation: correlation with allograft injury.
abstract: BACKGROUND
  Post-lung transplant reperfusion edema (PLTRE) and its more severe form, primary graft failure (PGF), occur in 10% to 60% of lung transplant recipients. We hypothesized that PLTRE and PGF would be associated with an elevated proinflammatory cascade and that the allograft would be the source of cytokine appearance in the circulation.
  
  
  METHODS
  Pulmonary arterial and systemic arterial samples were obtained at baseline and at 4, 8, and 24 hours after reperfusion. Post-lung transplant reperfusion-edema and PGF were defined as PaO2/FiO2 less than 300 with a mild or moderate infiltrate, or less than 200 with a severe infiltrate and ventilator dependence after 72 hours, respectively. Tumor necrosis factor alpha (TNFalpha), interleukin (IL)-6, IL-8, and IL-10 concentrations were determined by immunoassay.
  
  
  RESULTS
  Fifteen single and 6 bilateral lung recipients were studied. Six (29%) had PLTRE and 4 (19%) had PGF; these patients had an overall elevation in plasma IL-6, IL-8, and IL-10 concentrations (all p < 0.05). Subgroup analysis revealed a significantly greater elevation in IL-6, IL-8, and IL-10 levels in PGF patients (all p < 0.01) versus PLTRE. In the PGF group, TNFalpha and IL-10 concentrations were significantly greater in the systemic versus the pulmonary arterial samples (p < 0.05).
  
  
  CONCLUSIONS
  Patients with PLTRE and PGF exhibited graded increases in IL-6, IL-8, and IL-10 concentrations. The PGF patients had higher TNFalpha and IL-10 systemic arterial concentrations overall, consistent with the allograft being a source of this cytokine production.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Mathur
authors.forename: Maher
authors.initials: M
authors.lastname: Baz
authors.forename: E Denmark
authors.initials: ED
authors.lastname: Staples
authors.forename: Mark
authors.initials: M
authors.lastname: Bonnell
authors.forename: Jerry M
authors.initials: JM
authors.lastname: Speckman
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Hess
authors.forename: Charles T
authors.initials: CT
authors.lastname: Klodell
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Knauf
authors.forename: Lyle L
authors.initials: LL
authors.lastname: Moldawer
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Beaver
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016040:Lung Transplantation / Q000009:adverse effects / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000097:blood* / Q000209:etiology; D015427:Reperfusion Injury / Q000097:blood* / Q000209:etiology; D013997:Time Factors; D014184:Transplantation, Homologous; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10