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

doi:10.3877/cma.j.issn.2096-1537.2017.02.007

Abstract

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

Cheukfai Li, Yifan Xiang, Dongping Wang, Weiqiang Ju, Linwei Wu, Zhiyong Guo, Xiaoshun He. The level of inflammatory factor is associated with recipients survival after liver transplantation[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(02): 111-115.

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References 24

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时间	例数	TNF（ng/L）	IL-6（ng/L）	IL-10（ng/L）	BNP（ng/L）	PCT（μg/L）	Lac（mmol/L）
器官维护前	66	20.91±18.80	387.20±404.33	45.31±141.30	1377.12±4750.84	11.56±13.51	20.90±29.25
器官维护后	66	13.13±8.27	141.58±272.55	17.13±37.57	2730.75±5622.38	13.44±41.20	2.54±2.38
t值		-3.715	-4.052	-1.563	1.487	0.359	-5.005
P值		<0.001	<0.001	0.003	0.99	0.013	<0.001

时间	例数	TNF（ng/L）	IL-6（ng/L）	IL-10（ng/L）	BNP（ng/L）	PCT（μg/L）	Lac（mmol/L）
器官维护前	66	20.91±18.80	387.20±404.33	45.31±141.30	1377.12±4750.84	11.56±13.51	20.90±29.25
器官维护后	66	13.13±8.27	141.58±272.55	17.13±37.57	2730.75±5622.38	13.44±41.20	2.54±2.38
t值		-3.715	-4.052	-1.563	1.487	0.359	-5.005
P值		<0.001	<0.001	0.003	0.99	0.013	<0.001

影响因素		例数	半年生存率	χ²值	P值
供体TNF（ng/L）				6.176	0.029^a
	>18	12	58.3（12/66）
	≤18	54	87.0（54/66）
供体IL-6（ng/L）				0.830	0.387
	>180	13	84.6（13/66）
	≤180	53	81.1（53/66）
供体IL-10（ng/L）				0.004	0.951
	>20	10	70.0（10/66）
	≤20	56	83.9（56/66）
供体BNP （ng/L）				0.007	0.933
	>2500	13	76.9（13/66）
	≤2500	53	83.0（53/66）
供体PCT（μg/L）				0.010	0.339^a
	>23	8	62.5（8/65）
	≤23	57	84.2（57/65）
供体Lac（mmol/L）				0.026	0.871
	>3	10	50.0（10/64）
	≤3	54	87.0（54/64）
受体TBIL（μmol/L）				0.915	0.350
	>150	25	76.0（25/62）
	≤150	37	83.8（37/62）
受体ALT（U/L）				1.277	0.283^a
	>130	36	84.6（36/62）
	≤130	26	77.8（26/62）
受体INR				0.971	0.346^a
	>1.40	9	77.8（9/52）
	≤1.40	43	79.1（43/52）

影响因素		例数	半年生存率	χ²值	P值
供体TNF（ng/L）				6.176	0.029^a
	>18	12	58.3（12/66）
	≤18	54	87.0（54/66）
供体IL-6（ng/L）				0.830	0.387
	>180	13	84.6（13/66）
	≤180	53	81.1（53/66）
供体IL-10（ng/L）				0.004	0.951
	>20	10	70.0（10/66）
	≤20	56	83.9（56/66）
供体BNP （ng/L）				0.007	0.933
	>2500	13	76.9（13/66）
	≤2500	53	83.0（53/66）
供体PCT（μg/L）				0.010	0.339^a
	>23	8	62.5（8/65）
	≤23	57	84.2（57/65）
供体Lac（mmol/L）				0.026	0.871
	>3	10	50.0（10/64）
	≤3	54	87.0（54/64）
受体TBIL（μmol/L）				0.915	0.350
	>150	25	76.0（25/62）
	≤150	37	83.8（37/62）
受体ALT（U/L）				1.277	0.283^a
	>130	36	84.6（36/62）
	≤130	26	77.8（26/62）
受体INR				0.971	0.346^a
	>1.40	9	77.8（9/52）
	≤1.40	43	79.1（43/52）

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