title: Soluble tumor necrosis factor receptors as predictors of 1-year mortality and renal dysfunction after liver transplantation.
abstract: BACKGROUND
  Several risk factors influence survival after liver transplantation (LT). Some research has demonstrated a relationship between soluble tumor necrosis factor receptors (sTNFRs) and worse clinical liver disease outcomes, but there are no data showing an association between sTNFRs and outcomes after LT. The primary aim of this study was to determine whether an association exists between perioperative sTNFRs and renal dysfunction or mortality after LT.
  
  
  METHODS
  Data were collected prospectively from 122 patients submitted to deceased-donor orthotopic LT. Blood samples were collected at seven different perioperative times and analyzed by ELISA. The statistical analysis included univariate analysis followed by logistic regression. The predictive value of significant variables was assessed using ROC curves.
  
  
  RESULTS
  One-month and 1-year LT survivals were 91% and 81%, respectively. Increased levels of soluble tumor necrosis factor receptor 1 (sTNF-R1) after 24h of graft perfusion were associated with postoperative Renal Replacement Therapy (RRT) (OR 1.25) and 1-year mortality (OR 1.1). RRT was associated with 30-day and 1-year LT mortality, with OR 19.78 and 45.45, respectively.
  
  
  CONCLUSIONS
  A higher sTNF-R1 level measured 24h after graft perfusion is an independent predictor of RRT and 1-year mortality after LT.
authors: Federal University of Minas Gerais, Postgraduate Program of Surgery, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil. Electronic address: brunomoraisanest@yahoo.com.br.
authors: Bruno Salome
authors: BS
authors: Morais
authors: Federal University of Minas Gerais, Postgraduate Program of Infectious Diseases and Tropical Medicine, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil.
authors: Antonio Lucio
authors: AL
authors: Teixeira
authors: Federal University of Minas Gerais, Postgraduate Program of Surgery, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil.
authors: Jader Freitas
authors: JF
authors: Maciel
authors: Federal University of Minas Gerais, IAG, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil.
authors: Angela Aparecida
authors: AA
authors: Lima
authors: Federal University of Minas Gerais, Postgraduate Program of Neuroscience, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil.
authors: Izabela Guimaraes
authors: IG
authors: Barbosa
authors: Federal University of Minas Gerais, Professor of Surgery Department, Av. Professor Alfredo Balena, 110, Belo Horizonte, MG 30130-100, Brazil.
authors: Marcelo Dias
authors: MD
authors: Sanches
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D011237:Predictive Value of Tests; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood*; D051437:Renal Insufficiency / Q000097:blood* / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D012995:Solubility
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II
keywords: Cytokines; Liver transplantation; Mortality; Renal dysfunction; Soluble tumor necrosis factor receptors