title: The association of lipopolysaccharide and inflammatory factors with hepatopulmonary syndrome and their changes after orthotopic liver transplantation.
abstract: BACKGROUND
  The level of lipopolysaccharides (LPS) and inflammatory factors were higher in end stage liver disease patient than in normal person for the damage of intestinal mucosal barrier function. Hepatopulmonary syndrome (HPS) was a common pulmonary complication in end stage liver disease. But the association of LPS and inflammatory factors such as toll like receptor 2 (TLR2), TNF-α and ET-1 with the development of HPS was undefined.
  
  
  METHODS
  Thirty-one HPS patients were researched (26 patients were performed liver transplantation, five were not). Ten healthy volunteers were recruited as negative control. Blood was collected from the 26 HPS patients before and 3, 7, 14, 21 and 28 days after orthotopic liver transplantation (OLT), and from five HPS patients without OLT and ten healthy volunteers once to detect TLR2 mRNA and iNOS mRNA in peripheral blood monocytes and plasma LPS, TNF-α and ET-1 level. Their levels before and after OLT were compared.
  
  
  RESULTS
  TLR2 mRNA, iNOS mRNA, LPS, TNF-α and ET-1 before OLT in HPS patients were 336,594.1±366,901.1, 63,982.2±74,127.5 copies/ugRNA, 4.3±3.3, 90.1±76.0 and 319.9±124.4 ng/L, respectively. They were 10,338.3±3,814.6, 19,168.5±2,417.4 copies/ugRNA, 0.94±0.69, 2.7±0.1 and 84.2±10.6 ng/L in normal control group. They were significantly higher in HPS patients than those in control group (P<0.05). After OLT, liver function improved to normal. Also TLR2 mRNA, TNF-α and ET-1 decreased in HPS patients after OLT compared with those before OLT. And PaO2 and PaO2/FiO2 improved greatly with intrapulmonary shunt decreased to normal after OLT.
  
  
  CONCLUSIONS
  Lipopolysaccharides at the end stage of liver disease with the release of series of inflammatory factors may be associated with the development of HPS.
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Huimin
authors.initials: H
authors.lastname: Yi
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Yuling
authors.initials: Y
authors.lastname: An
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Haijin
authors.initials: H
authors.lastname: Lv
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Xuxia
authors.initials: X
authors.lastname: Wei
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Yi
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Genshu
authors.initials: G
authors.lastname: Wang
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Guihua
authors.initials: G
authors.lastname: Chen
authors.affiliation: 1 Liver Transplantation Center, 2 SICU, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
authors.forename: Shuhong
authors.initials: S
authors.lastname: Yi
keywords: Hepatopulmonary syndrome (HPS); inducible nitric oxide synthase (iNOS); mechanism; orthotopic liver transplantation (OLT); tissue necrosis factor alpha (TNF-α); toll-like receptor (TLR)