Local secretion of TNF-alpha from the liver does not correlate with endotoxin, IL-6, or organ function in the early phase after orthotopic liver transplantation

Hepatic ischemia/reperfusion leads to an excessive release of proinflammato ry cytokines, which promotes local and remote cell damage. The value of cyt okine measurement in humans for predicting graft function after orthotopic liver transplantation (OLT) remains unclear. Therefore, in this study, tumo r-necrosis-factor-alpha (TNF-alpha), interleukin-6 (IL-6), and endotoxin (E T) levels were determined in the blood taken from the hepatic veins of 31 p atients who underwent OLT. Peak levels of TNF-alpha in hepatic venous blood were measured shortly after reperfusion and were significantly higher than concentrations in the systemic circulation. IL-6 concentrations, peaking 9 0 min after reperfusion, only correlated with postoperative pulmonary dysfu nction. ET was detectable in 21 patients, but levels did not correlate with either IL-6 or TNF-alpha concentrations. Additionally, serum cytokine leve ls did not correlate with the duration of ischemia or with histological cha nges seen in liver biopsies. In general, our study suggests that local secr etion of cytokines does not predict liver function in the early posttranspl ant phase.