Component and Levels of TNF-α, IL-1β, and IL-8 in Bronchoalveolar Lavage Fluid and Plasma during Liver Transplantation and Their Relation to Postoperative Acute Lung Injury

[Objective] To observe the changes of components and levels of TNF-α, IL-1β, and IL-8 in bronchoalveolar lavage fluid (BALF) and plasma during orthotopic liver transplantation (OLT) and to investigate the relationship between the changes and postoperative acute lung injury(ALI). [Methods] Twenty-nine patients with end-stage liver disease undergoing OLT were enrolled. Arterial blood samples and BALF from the middle lobe of right lung were collected at 2 intervals: after induction (T1) and 120 min after reperfusion (T2) for determinating lung permeability index (BALE protein concentration/serum protein concentration), the differential cells in BALF, the content of total phospholipids, and the levels of IL-1β, IL-8, and TNF-α both in BALF and serum. The patients were divided into two groups: ALI group (group A) and Non-ALI group (group N). [Results]Nine patients (31%) took place with ALI following OLT. The proportion of alveolar macrophage was significantly decreased at T1 in group A while total protein of BALF and lung permeability index significantly increased at T2 compared with group N (P 0.05). Compare with T1, the total protein and phospholipids of BALF, lung permeability index significantly increased at T2 (P 0.05). The concentration of TNF-α in serum and BALF, and IL-1β in BALF at T2 in group A were significantly increased compared with T1 and group N (P 0.05). There was no significant difference of the concentration of IL-8 between the two groups. The proportion of macrophage at T1, lung permeability index, concentration of TNF-α and IL-1β in BALF, and concentration of TNF-α in serum at T2 were related to postoperative ALI respectively (P 0.05). [Conclusions] The changes of components and levels of TNF-α, IL-1β, IL-8 in BALF and plasma will be appear in 120 min after reperfusion. It seems more prominence in group ALI. Paying attention to lung protection and alleviating inflammatory reaction may be helpful to prevent the appearance of ALI during OLT.