The ratio of plasma interleukin-18 is a sensitive biomarker for acute kidney injury after liver transplantation.
BACKGROUND
Acute kidney injury (AKI) is common after liver transplantation (OLT) and is associated with high morbidity and mortality. Previous studies have shown that interleukin-18 (IL-18) levels are associated with AKI. The purpose of this study was to determine whether plasma IL-18 levels were early predictors for AKI after liver transplantation.


METHODS
Plasma samples were obtained from 26 patients who underwent OLT at induction of anesthesia (T1), 1 hour after the surgical incision (T2), the time of reperfusion (T3), as well as 1 (T4), 2 (T5), and 4 hours (T6) after reperfusion. Samples were also obtained at 24 hours after surgery (T7). The AKI criteria were taken according to the Acute Kidney Injury Network criteria.


RESULTS
Twelve patients (46%) developed AKI after OLT. The area under the receiver operating curve of plasma IL-18 concentrations (T4/T1) to predict AKI occurrence was 0.842 at T5, 0.905 at T6, 0.726 at T7, and 0.726 at T5 to T7.


CONCLUSIONS
Plasma IL-18 concentrations taken 1 hour after reperfusion were predictive of AKI. Therefore, changing IL-18 ratio may be an early predictor for AKI after OLT.
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
W-C
WC
Sung
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: yuhp2001@adm.cgmh.org.tw.
H-P
HP
Yu
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
Y-F
YF
Tsai
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
P C-H
PC
Chung
Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
C-C
CC
Lin
College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Division of Transplantation and Liver Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
W-C
WC
Lee
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D007668:Kidney / Q000503:physiopathology*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D020382:Interleukin-18