Recipient Cytokine Levels Are Associated with Primary Cardiac Allograft Failure

Abstract

<h3>Purpose</h3> Primary graft failure (PGF) is a devastating complication that could occur immediately after heart transplantation (HTx). The risk factors related to heart grafts were reported before. However, the hostile environment of the recipient is poorly understood. We hypothesize that the recipient cytokine profiles is associated with a recipient's propensity for PGF. The aim of this study was to investigate the pre and postoperative cytokine concentration in patients with PGF. <h3>Methods and Materials</h3> Thirty-two consecutive patients undergoing HTx between 2006 and 2012 at our hospital were reviewed retrospectively. Interleukin (IL)-6, IL-8, Heart type fatty acid-binding protein (H-FABP), and Troponin-T (TnT) levels were measured before reperfusion of transplanted hearts, 1, 3, and 24 hours after reperfusion respectively. PGF was defined as significant impairment of systolic graft function requiring mechanical circulatory support within the first 24 hours after HTx. Cytokine levels at each point were compared between patients with PGF and without PGF. <h3>Results</h3> Of 31 patients, 9 (29%) developed PGF. There was no significant difference in recipients' demographics between the two groups. Patients with PGF had higher baseline levels of IL-6 (1560.7±723.3 pg/ml vs. 241.7±462.6 pm/ml; p=0.12) and IL-8 (94.7±22.6pg/ml vs. 41.6±14.5 pm/ml; p=0.05). One hour after HTx, the levels of the IL-6 (6373.3±2189.9 pg/ml vs. 956.5±1400.7 pm/ml; p<0.05) and IL-8 (263.9±53.5 pg/ml vs. 105.7±34.2 pm/ml; p=0.02) in patients with PGF were higher than patients without PGF. [figure 1] <h3>Conclusions</h3> Higher cytokine levels just before and 1 hour after reperfusion of the graft were associated with PGF. These results may support a potential strategy for anti-inflammatory therapies before transplant.