21 May 2009
Ann Transplant 2009; 14(1): 27-27 :: ID: 880295
Background: Inï¬‚ammatory response with increased serum cytokines has been
studied in brain-dead donors. However the significance of this phenomenon and its effect on post transplant organ function is very poorly understood. The aim of this study was to correlate levels of cytokine panel in the donor with early and long-term renal and liver graft function.
Material/Methods: Blood samples were drawn from 67 brain dead kidney and 20 liver donors immediately prior to organ retrieval. Samples were centrifuged and sera were deep-frozen (-80%u207°C) and stored until further analysis. Concentrations of IL1b, IL2, IL4, IL6, IL8, IL10, IL12p70, TNFa, IFNg and GMCSF were later determined with Bedlyte human multicytokine detection system 3 on Luminex 100 hardware. Kidneys were transplanted into 132 ESRD patients. Demographic and clinical donor's and recipient's data was obtained and analyzed. Post-transplant kidney and liver function was assessed daily for the first two weeks and periodically thereafter. Mean follow up was 35.1 months after kidney transplantation and 22.5 months after OLTx.
Results: Kidneys with delayed post-transplant function were harvested from the donors with higher serum IL-1B (14.1±14.6 vs. 7.42±10.8 pg/ml; p<0.004), IL-4 (5.23±3.2 vs. 4.07±2.7 pg/ml; p<0.03) and IL-6 (954±1113 vs. 495±834 pg/ml; p<0.009). Lower donor serum IL-12 was associated with acute kidney graft rejection during 6 months after transplantation (1.32 vs. 6,.52 pg/ml in no rejection group; p<0.007). Not very strong (r=0.22), however significant correlation of donor IL6 and IL8 with recipient's serum creatinine could have been noted until 6 months post-transplant. The effect was lost completely later on. All measured cytokines but IFN and GMCSF showed strong, positive correlation with early post transplant OLTx recipient's AST and INR. With time, this correlation was gradually lost and was not seen after day 10. Only IL-4 affected liver function until one month after transplantation.
Conclusion: Inï¬‚ammatory response observed in brain dead donors affects early, but not long term, the liver graft's function.
Keywords: Deceased Donor, Kidney Transplantation, clinical outcome
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