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Early Release of Proinflammatory Cytokines After Lung Transplantation FREE TO VIEW

Hervé Mal; Monique Dehoux; Charles Sleiman; Jorge Boczkowski; Guy Lesèche; René Pariente; Michel Fournier
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From the Service de Pneumologie et Réanimation Respiratoire and Service de Chirurgie Thoracique et Vasculaire, Hôpital Beaujon, Clichy, Unité Inserm 408, Paris, France

1998 by the American College of Chest Physicians

Chest. 1998;113(3):645-651. doi:10.1378/chest.113.3.645
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Background: Systemic hypotension may complicate the early postoperative period after lung transplantation. A release of proinflammatory cytokines secondary to lung ischemia/reperfusion injury could be involved in the pathogenesis of this early hemodynamic failure (EHF).

Study objective: To assess prospectively whether the occurrence of EHF is associated with a release of cytokines in the systemic circulation.

Design: Blood samples were taken daily during the first postoperative week in 26 patients who underwent a double or a single-lung transplantation. These patients were divided into three groups: 7 patients who experienced EHF and subsequently died (EHF group); 15 patients without EHF (control group); and 4 patients without EHF but with an identified sepsis (sepsis group). The serum levels of interleukin (IL)-1β, tumor necrosis factor-α (TNF-α), IL-6, and IL-8 were compared among the three groups.

Results: In the EHF group, the levels of each cytokine peaked at day 1 postoperatively. Cytokine levels at day 1 were significantly higher in the EHF group than in the control group (p<0.0006) or in the sepsis group (p<0.003 except for TNF-α).

Conclusion: We conclude that EHF is associated with a massive release of proinflammatory cytokines that could play a determinant role in the pathogenesis of this complication.




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