Ischemic reperfusion injury-induced oxidative stress and pro-inflammatory mediators in liver transplantation recipients

Transplant Proc. 2014 May;46(4):1082-6. doi: 10.1016/j.transproceed.2014.01.009.

Abstract

Objective: Liver ischemic reperfusion injury is harmful to transplant recipients, and is associated with postoperative morbidity and mortality. Our study was designed to investigate the oxidative stress and pro-inflammatory mediators in liver transplant recipients.

Methods: We prospectively analyzed 14 recipients who underwent liver transplantation by measuring their blood levels of malondialdehyde (MDA) and cytokines, such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, at nine time points perioperatively. We also evaluated the correlations between oxidative stress (MDA levels) and the characteristics of the recipient or the donated graft.

Results: These parameters significantly increased from 1 minute before reperfusion, and the values peaked within 3 to 30 minutes after reperfusion. On the time point at 5 minutes after reperfusion, the MDA levels which were the highest in the recipients correlated with the values of preoperative direct/and total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), model for end-stage liver disease (MELD) score, international normalized ratio (INR), and surgical blood loss.

Conclusion: The levels of MDA, TNF-α, IL-1β, and IL-6 greatly increased with the ischemic reperfusion insult. Recipients with higher values of preoperative direct/and total bilirubin, AST, ALT, MELD score, INR, and surgical blood loss tended to have higher levels of MDA and may suffer more injury from this insult.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Humans
  • Inflammation / blood
  • Inflammation / diagnosis
  • Inflammation / etiology*
  • Inflammation Mediators / blood*
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / surgery*
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / surgery*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Oxidative Stress*
  • Prospective Studies
  • Reperfusion Injury / blood
  • Reperfusion Injury / diagnosis
  • Reperfusion Injury / etiology*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Inflammation Mediators