Analysis of interleukin-6 and interleukin-8 in lung transplantation: correlation with nitric oxide administration.
OBJECTIVE
Primary graft dysfunction (PGD) following lung transplantation (LT) is associated with an activation of the inflammatory cascade and release of cytokines. Inhaled nitric oxide (iNO) provides specific pulmonary vasodilatation and improves oxygenation. Our objective was to verify whether administering iNO to LT patients modified the blood and bronchoalveolar lavage (BAL) interleukin (IL)-6 and -8 levels in the event of PGD.


METHODS
Thirty-two LT patients were randomized to the iNO treatment or the control group. Patients in the first group were given 10 ppm of iNO from the start of LT until 48 hours afterward. BAL and peripheral arterial blood samples were taken preimplantation as well as 12, 24, as and 48 hours postreperfusion.


RESULTS
The iNO treatment group showed a lower incidence of PGD (29%) in comparison with the control group (40%). Significant differences (P < .05) were observed in the iNO group, with lower IL-6 levels at 12 hours in blood and BAL. A lower percentage of IL-8 was also detected in the iNO group at 24 hours in BAL and at 12 hours in blood and BAL.


CONCLUSIONS
Lung transplant recipients develop an inflammatory response following implantation with systemic elevation of IL-6 and significant local elevation of IL-8 within the first few hours, especially in the event of PGD. In our series, iNO appeared to modulate the inflammatory response by reducing IL concentrations found immediately after reimplantation, and this reduction was related to a lower incidence of PGD.
Moreno
I
I
Department of Anesthesiology, Hospital Universitario La Fe, Universidad de Valencia, Valencia, Spain. nachomoreno@ono.com
Mir
A
A
Vicente
R
R
Pajares
A
A
Ramos
F
F
Vicente
J L
JL
Barbera
M
M
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D016040:Lung Transplantation / Q000502:physiology*; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D055815:Young Adult
D001993:Bronchodilator Agents; D015850:Interleukin-6; D016209:Interleukin-8; D009569:Nitric Oxide