title: Inflammatory cytokines during liver transplantation: prospective randomized trial comparing conventional and piggyback techniques.
abstract: OBJECTIVE
  Cytokines have a significant role in the response to injury following liver transplantation, but the origin and course of such molecules are not completely known. The aim of this study was to evaluate the production and liver metabolism of the inflammatory cytokines interleukin (IL)-1beta, IL-6, IL-8, interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha in orthotopic liver transplantation (OLT), comparing the conventional and the piggyback methods.
  
  
  METHODS
  We performed a study of 30 patients who underwent elective OLT and were randomized for the conventional or piggyback techniques at the beginning of the operation. The amount of cytokines and their hepatic metabolism were calculated based on plasma concentrations and vascular blood flow at 2, 5, 10, 15, 30, 60, 90, and 120 minutes after revascularization.
  
  
  RESULTS
  The amount of IL-11 in portal blood was higher in patients who underwent surgery using the conventional technique (estimate interest = 63,783.9 +/-16,586.1 pg/min, versus 11,979.6 +/-16,585.7 pg/min in the piggyback group, p = 0.035). There were no significant differences between the two operative's methods for IL-6, IL-8, IFN-gamma and TNF-alpha production. The hepatic metabolism of cytokines was not different between groups. Although all the curves showed higher amounts of cytokines with the conventional technique, these were not statistically significant.
  
  
  CONCLUSIONS
  The study shows the similarity between the two techniques concerning the stimuli for the production of inflammatory molecules.
authors: Liver Unit, Instituto Dante Pazzanese de Cardiologia, S. Paulo, Brazil.
authors: Carlos Eduardo Sandoli
authors: CE
authors: Baía
authors: Edson
authors: E
authors: Abdala
authors: Paulo
authors: P
authors: Massarollo
authors: Thiago
authors: T
authors: Beduschi
authors: Thomson Marques
authors: TM
authors: Palma
authors: Sergio
authors: S
authors: Mies
mesh_terms: D000328:Adult; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D016209:Interleukin-8 / Q000378:metabolism; D008099:Liver / Q000378:metabolism*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha