Inflammatory cytokines during liver transplantation: prospective randomized trial comparing conventional and piggyback techniques.
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.
Baía
Carlos Eduardo Sandoli
CE
Liver Unit, Instituto Dante Pazzanese de Cardiologia, S. Paulo, Brazil.
Abdala
Edson
E
Massarollo
Paulo
P
Beduschi
Thiago
T
Palma
Thomson Marques
TM
Mies
Sergio
S
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
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha