TY - JOUR
T1 - Gastro-intestinal complement activation during human liver transplantation
T2 - Impact on postoperative liver function
AU - RØnholm, Ebbe
AU - Tomasdottir, H.
AU - Runeborg, J.
AU - Mattsby-Baltzer, I.
AU - Olausson, M.
AU - Åneman, A.
AU - Bengtsson, A.
PY - 2000
Y1 - 2000
N2 - Background: Liver transplantation elicits a systemic inflammatory, response and eventually a multiple organ failure syndrome. Gastro-intestinal inflammatory activation with release of proinflammatory cytokines and complement activation may occur. This study evaluates gastro-intestinal complement activation and the association with postoperative parenchymatous liver cell injury and liver dysfunction. Methods: In 17 patients undergoing liver transplantation, blood samples were collected from radial artery, and portal vein for analysis of complement SC5b-9 and endotoxin concentration. Portal venous-arterial SC5b-9 plasma concentration gradients at 30 min after reperfusion were calculated. Outcome parameters included postoperative organ failure and serum concentrations of aspartate aminotransferase, alanine aminotransferase, bilirubin and factor II-VII-X. Results: Patients with gastro-intestinal SC5b-9 release (n=7) had higher postoperative serum aspartate aminotransferase and alanine aminotransferase concentrations [49 (32-80) μkat/l vs 8 (6-14) μkat/l, P<0.01 and 33 (15-54) μkat/l vs 8 (4-23) μkat/l, P<0.04, respectively] and lower factor II-VII-X concentrations [46 (21-48)% vs 60 (47-69)%, P<0.02] compared to patients without gastro-intestinal SC5b-9 release (n=10). The ICU stay was prolonged in patients with gastro-intestinal complement release. There was no difference in number of organ failures and serum bilirubin concentration between the groups. The endotoxin concentration in arterial and portal vein blood was low and the association between endotoxaemia and complement activation was poor. Conclusion: Gastro-intestinal complement activation may contribute to postoperative parenchymatous liver cell injury and liver dysfunction in patients undergoing liver transplantation. (C) Acta Anaesthesiologica Scandinavica 44 (2000).
AB - Background: Liver transplantation elicits a systemic inflammatory, response and eventually a multiple organ failure syndrome. Gastro-intestinal inflammatory activation with release of proinflammatory cytokines and complement activation may occur. This study evaluates gastro-intestinal complement activation and the association with postoperative parenchymatous liver cell injury and liver dysfunction. Methods: In 17 patients undergoing liver transplantation, blood samples were collected from radial artery, and portal vein for analysis of complement SC5b-9 and endotoxin concentration. Portal venous-arterial SC5b-9 plasma concentration gradients at 30 min after reperfusion were calculated. Outcome parameters included postoperative organ failure and serum concentrations of aspartate aminotransferase, alanine aminotransferase, bilirubin and factor II-VII-X. Results: Patients with gastro-intestinal SC5b-9 release (n=7) had higher postoperative serum aspartate aminotransferase and alanine aminotransferase concentrations [49 (32-80) μkat/l vs 8 (6-14) μkat/l, P<0.01 and 33 (15-54) μkat/l vs 8 (4-23) μkat/l, P<0.04, respectively] and lower factor II-VII-X concentrations [46 (21-48)% vs 60 (47-69)%, P<0.02] compared to patients without gastro-intestinal SC5b-9 release (n=10). The ICU stay was prolonged in patients with gastro-intestinal complement release. There was no difference in number of organ failures and serum bilirubin concentration between the groups. The endotoxin concentration in arterial and portal vein blood was low and the association between endotoxaemia and complement activation was poor. Conclusion: Gastro-intestinal complement activation may contribute to postoperative parenchymatous liver cell injury and liver dysfunction in patients undergoing liver transplantation. (C) Acta Anaesthesiologica Scandinavica 44 (2000).
KW - Complement
KW - Endotoxin
KW - Gastrointestinal system
KW - Inflammatory mediators
KW - Liver transplantation
KW - Multiple organ failure
KW - Reperfusion
UR - http://www.scopus.com/inward/record.url?scp=0033943652&partnerID=8YFLogxK
U2 - 10.1034/j.1399-6576.2000.440711.x
DO - 10.1034/j.1399-6576.2000.440711.x
M3 - Article
C2 - 10939698
AN - SCOPUS:0033943652
SN - 0001-5172
VL - 44
SP - 850
EP - 857
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
IS - 7
ER -