DIFFERENTIAL CONTRIBUTION OF GRAFT AND RECIPIENT TO PERIOPERATIVE TNF-ALPHA, IL-1-BETA, IL-6 AND IL-8 LEVELS AND CORRELATION WITH EARLY GRAFT FUNCTION IN CLINICAL LIVER-TRANSPLANTATION

Cytokines, produced by both the recipient and the newly vascularized a llograft, are central mediators in the inflammatory response to allogr afted tissue. This study examines the relationship between pre-and int raoperative levels of TNF IL-1, IL-6, and IL-8 and hepatic allograft f unction in the early postoperative period and also determines which cy tokines are produced in a significant amount by the newly vascularized allograft. Baseline levels of IL-6 and IL-8 tended to be higher in pa tients with more advanced disease and showed an increase during the an hepatic period. TNF and IL-1 remained stable from baseline to anhepati c phase. IL-1 showed an increase from portal vein to effluent samples, suggesting that the graft has an important contribution to circulatin g IL-1 levels. Analysis of the data according to early graft performan ce revealed extremely high levels of effluent IL-1, IL-6 and IL-8, and the prolonged elevation of the latter two cytokines in patients with poor early graft function. Our findings demonstrate that sequential pe rioperative measurements of proinflammatory cytokines can be useful in monitoring graft function.