P183 Serum cytokines as predictors of liver graft dysfunction based on the model for end-stage liver disease score in patients undergoing living donor liver transplantation

Abstract

Aim The Model for End-stage Liver Disease (MELD) score was developed as a tool for evaluating residual liver function in patients with liver disease. Nowadays, the usefulness of the MELD score is widely acknowledged and it is used as a reference to assess eligibility of patients for liver transplantation. Because the recipient’s immune status influences liver graft function, we expected the MELD score also would be affected. Thus, we compared the MELD score based on the immune status measured by the level of serum cytokines (immune mediators), and evaluated the usefulness of serum cytokines as a prognostic indicator of liver graft function. Methods We enrolled 171 patients in a retrospective study at Seoul St. Mary’s Hospital between January 2009 and March 2016. Demographic, clinical and biochemical data were obtained. Serum cytokines levels were measured using a sandwich enzyme immunoassay test kit in the immediate post-transplant period. The MELD scores were calculated on 1 day (D), D2, D3, D7, D10, D15, and D30 post-transplantation. Seven serum cytokines were measured: interferon (IFN)- γ , interleukin (IL)-10, IL-12, IL-17, IL-2, IL-6 and tumor necrosis factor (TNF)- α . We investigated the influence of serum cytokines on MELD scores based on Pearson correlation coefficient using correlation analysis. Results Four cytokines, viz., IFN- γ , IL-10, IL-6, and TNF- α were significantly correlated with post-transplant MELD scores (p γ showed a statistically significant correlation with the MELD score only on post-transplant D1, IL-10 on D30, IL-6 after post-transplant D3, and TNF- α after D2. Conclusions The levels of serum cytokines, viz., IL-6 and TNF- α , which are pro-inflammatory cytokines, are strongly correlated with post-transplant MELD scores. Therefore, IL-6 and TNF- α could be useful predictors of liver graft dysfunction in patients undergoing living donor liver transplantation. Download high-res image (367KB) Download full-size image