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2017•Chin J Crit Care Intensive Care MedRequires access

The level of inflammatory factor is associated with recipients survival after liver transplantation

Cheukfai Li, Yifan Xiang, Dongping Wang, Weiqiang Ju, Linwei Wu, Zhiyong Guo

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Abstract

Objective To investigate the effect of inflammatory factors of donors before liver harvest and early postoperative clinical parameters of recipientson the survival of recipients and the meaning of donor maintenance in liver transplantation. Methods Retrospective analysis clinical data of 66 patients who received hepatic allografts in the First Affiliated Hospital of Sun Yat-sen University from 2015 February to 2016 July. Tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-10 (IL-10), brain natriuretic peptide (BNP), procalcitonin (PCT), lactic acid (Lac) of donors before and after the donor maintenance and total bilirubin (TBIL), alkaline phosphatase (ALT), international normalized ratio (INR) of recipients was measured. Paired t-test was performed to analyse the difference of donor inflammatory factors before and after the donor maintenance. Chi square test and Cox regression model were performed to analyze the risk factors of recipients survival after transplantation. Results After donor maintenance, The level of TNF and IL-6 were significantly reduced [ (13.13±8.27) ng/L vs (20.91±18.80) ng/L, (141.58±272.55) ng/L vs (387.20±404.33) ng/L, t=-3.715, -4.052, both P<0.001]. The univariate analysis revealed that the level of TNF, PCT of donors, and the level of INR, ALT of recipients were the independent risk factors of short-term survival in liver transplantation patients (χ2=6.176, P=0.029; χ2=0.010, P=0.339; χ2=0.971, P=0.346; χ2=1.277, P=0.283). However, the COX multivariate regression analysis revealed that only the level of TNF before donor liver harvest was the independent risk factor of short-term survival in liver transplantation patients (RR 1.138, 95% CI 0.000-0.309, P=0.001). Conclusions Increased level of TNF of donors before harvest was associated with the survival of recipients. Donor maintenance could reduce the TNF level and further improve the survival of recipients. Key words: Liver transplantation; Donor maintenance; Tumor Necrosis Factor; Recipient survival

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What this paper is about

Objective To investigate the effect of inflammatory factors of donors before liver harvest and early postoperative clinical parameters of recipientson the survival of recipients and the meaning of donor maintenance in liver transplantation. Methods Retrospective analysis clinical data of 66 patients who received hepatic allografts in the First Affiliated Hospital of Sun Yat-sen University from 2015 February to 2016 July. Tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-10 (IL-10), brain natriuretic peptide (BNP), procalcitonin (PCT), lactic acid (Lac) of donors before and after the donor maintenance and total bilirubin (TBIL), alkaline phosphatase (ALT), international normalized ratio (INR) of recipients was measured. Paired t-test was performed to analyse the difference of donor inflammatory factors before and after the donor maintenance. Chi square test and Cox regression model were performed to analyze the risk factors of recipients survival after transplantation. Results After donor maintenance, The level of TNF and IL-6 were significantly reduced [ (13.13±8.27) ng/L vs (20.91±18.80) ng/L, (141.58±272.55) ng/L vs (387.20±404.33) ng/L, t=-3.715, -4.052, both P<0.001]. The univariate analysis revealed that the level of TNF, PCT of donors, and the level of INR, ALT of recipients were the independent risk factors of short-term survival in liver transplantation patients (χ2=6.176, P=0.029; χ2=0.010, P=0.339; χ2=0.971, P=0.346; χ2=1.277, P=0.283). However, the COX multivariate regression analysis revealed that only the level of TNF before donor liver harvest was the independent risk factor of short-term survival in liver transplantation patients (RR 1.138, 95% CI 0.000-0.309, P=0.001). Conclusions Increased level of TNF of donors before harvest was associated with the survival of recipients. Donor maintenance could reduce the TNF level and further improve the survival of recipients. Key words: Liver transplantation; Donor maintenance; Tumor Necrosis Factor; Recipient survival

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Available abstract

Objective To investigate the effect of inflammatory factors of donors before liver harvest and early postoperative clinical parameters of recipientson the survival of recipients and the meaning of donor maintenance in liver transplantation. Methods Retrospective analysis clinical data of 66 patients who received hepatic allografts in the First Affiliated Hospital of Sun Yat-sen University from 2015 February to 2016 July. Tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-10 (IL-10), brain natriuretic peptide (BNP), procalcitonin (PCT), lactic acid (Lac) of donors before and after the donor maintenance and total bilirubin (TBIL), alkaline phosphatase (ALT), international normalized ratio (INR) of recipients was measured. Paired t-test was performed to analyse the difference of donor inflammatory factors before and after the donor maintenance. Chi square test and Cox regression model were performed to analyze the risk factors of recipients survival after transplantation. Results After donor maintenance, The level of TNF and IL-6 were significantly reduced [ (13.13±8.27) ng/L vs (20.91±18.80) ng/L, (141.58±272.55) ng/L vs (387.20±404.33) ng/L, t=-3.715, -4.052, both P<0.001]. The univariate analysis revealed that the level of TNF, PCT of donors, and the level of INR, ALT of recipients were the independent risk factors of short-term survival in liver transplantation patients (χ2=6.176, P=0.029; χ2=0.010, P=0.339; χ2=0.971, P=0.346; χ2=1.277, P=0.283). However, the COX multivariate regression analysis revealed that only the level of TNF before donor liver harvest was the independent risk factor of short-term survival in liver transplantation patients (RR 1.138, 95% CI 0.000-0.309, P=0.001). Conclusions Increased level of TNF of donors before harvest was associated with the survival of recipients. Donor maintenance could reduce the TNF level and further improve the survival of recipients. Key words: Liver transplantation; Donor maintenance; Tumor Necrosis Factor; Recipient survival

Key concepts: Medicine, Internal medicine, Gastroenterology, Procalcitonin, Liver transplantation, Transplantation, Proportional hazards model, Univariate analysis

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