The association of promoter gene polymorphisms of the tumor necrosis factor-α and interleukin-10 with severity of lactic acidosis during liver transplantation surgery.
BACKGROUND
Orthotopic liver transplantation (OLT) is a major operation, causing cytokine release and other inflammatory responses that can contribute to postreperfusion syndrome occurrence. During the systemic inflammatory response syndrome, increased lactate levels result from excessive cytokine production despite normal oxygen delivery and carbohydrate metabolism. The goal of the study was to determine the relationship between genetic polymorphisms in interleukin (IL)-10 (-1082G/A) or tumor necrosis factor (TNF)-α (-376 G/A) and lactate levels in patients during OLT surgery.


METHODS
This prospective observational study in 40 consecutive adult patients who underwent OLT documented lactic acid levels at 5 times: Immediately after induction of anesthesia, at the end of the pre-anhepatic phase, at the end of the anhepatic phase, 1 hour after reperfusion, and at the end of surgery. Polymerase chain reaction (PCR; RFLP methodology) was used to examine IL-10 (-1082G/A) and TNF-α (-376 G/A) gene polymorphisms.


RESULTS
Carriers of the IL-10/TNF-α genotype combination GG/GG showed significantly different changes in lactate levels at 1 hour after reperfusion and at the end of surgery. Lactate levels were significantly higher among patients heterozygous for TNF-α (AG genotype) compared with patients homozygous for TNF-α (GG genotype) at same times. In contrast, there was no significant difference among IL-10 polymorphic genotypes (-1082G/A).


CONCLUSIONS
Genetic factors play a role in the development of lactic acidosis after OLT. IL-10 (-1082G/A) and TNF-α (-376 G/A) gene polymorphisms could influence the variability of lactate levels after liver transplantation surgery.
Department of Anesthesia, Kaser Al-Aini Hospital Cairo University, Cairo, Egypt. os_as_kh_2004@yahoo.com
O
O
Farahat
M
M
Salah
A
A
Mokhtar
F
F
Abouelfetoh
D
D
Labib
H
H
Baz
D000140:Acidosis, Lactic / Q000097:blood / Q000209:etiology / Q000235:genetics* / Q000276:immunology; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004534:Egypt; D005260:Female; D020022:Genetic Predisposition to Disease; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D016753:Interleukin-10 / Q000235:genetics*; D019344:Lactic Acid / Q000097:blood; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
D015415:Biomarkers; C508609:IL10 protein, human; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D019344:Lactic Acid