title: Early post-operative measurement of cytokine plasma levels combined with pre-operative bilirubin levels identify high-risk patients after liver resection.
abstract: Identification of patients at risk of a complicated course after liver resection is crucial for adapting post-operative care. In the present study, we investigated the diagnostic value of the plasma levels of various cytokines obtained immediately after surgery. IL-6, IL-10, IL-8, monokine induced by interferon-γ (MIG), monocyte chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) concentrations were measured in 26 patients after liver resection using a cytometric bead assay and were correlated with liver function, resectate weight, surgery duration, ischemia/reperfusion, hospitalization time and occurrence of complications. Patients with post-surgical complications showed distinctive patterns of IL-6 and IL-8 as early as minutes to hours after surgery. In addition, although pre-operative bilirubin in most patients remained within the normal range, a cut-off of 1 mg/dl separated the patients into groups with different profiles of IL-6, IL-8, and MCP-1 secretion and different likelihoods of experiencing post-operative complications (bilirubin levels ≥1.0 vs. <1.0 mg/dl; IL-6 (4 h): 701 vs. 265; IL-8 (6 h): 262 vs. 97 pg/ml; p<0.05 for both). Extended hospitalization, related to delayed recovery, was correlated with increased IL-8 and MCP-1 immediately after surgery. In conclusion, on the basis of these observations, we suggest that early measurement of post-operative levels of MCP-1, IL-6, and IL-8 can be used to identify individuals at risk of post-operative complications immediately after liver surgery.
authors.affiliation: Department of General and Vascular Surgery, Johann Wolfgang Goethe-University Frankfurt, Theodor-Stern-Kai 7, D-60590 Frankfurt am Main, Germany. strey@gmx.de
authors.forename: Christoph W
authors.initials: CW
authors.lastname: Strey
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Marquez-Pinilla
authors.forename: Maciej M
authors.initials: MM
authors.lastname: Markiewski
authors.forename: Britta
authors.initials: B
authors.lastname: Siegmund
authors.forename: Elsie
authors.initials: E
authors.lastname: Oppermann
authors.forename: John D
authors.initials: JD
authors.lastname: Lambris
authors.forename: Wolf O
authors.initials: WO
authors.lastname: Bechstein
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D008099:Liver / Q000378:metabolism* / Q000601:surgery; D008107:Liver Diseases / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D057234:Preoperative Period; D015427:Reperfusion Injury / Q000097:blood; D013997:Time Factors
chemical_list: D016207:Cytokines; D001663:Bilirubin