Early post-operative measurement of cytokine plasma levels combined with pre-operative bilirubin levels identify high-risk patients after liver resection

Int J Mol Med. 2011 Mar;27(3):447-54. doi: 10.3892/ijmm.2010.592. Epub 2010 Dec 28.

Abstract

Identification of patients at risk of a complicated course after liver resection is crucial for adapting post-operative care. In the present study, we investigated the diagnostic value of the plasma levels of various cytokines obtained immediately after surgery. IL-6, IL-10, IL-8, monokine induced by interferon-γ (MIG), monocyte chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) concentrations were measured in 26 patients after liver resection using a cytometric bead assay and were correlated with liver function, resectate weight, surgery duration, ischemia/reperfusion, hospitalization time and occurrence of complications. Patients with post-surgical complications showed distinctive patterns of IL-6 and IL-8 as early as minutes to hours after surgery. In addition, although pre-operative bilirubin in most patients remained within the normal range, a cut-off of 1 mg/dl separated the patients into groups with different profiles of IL-6, IL-8, and MCP-1 secretion and different likelihoods of experiencing post-operative complications (bilirubin levels ≥1.0 vs. <1.0 mg/dl; IL-6 (4 h): 701 vs. 265; IL-8 (6 h): 262 vs. 97 pg/ml; p<0.05 for both). Extended hospitalization, related to delayed recovery, was correlated with increased IL-8 and MCP-1 immediately after surgery. In conclusion, on the basis of these observations, we suggest that early measurement of post-operative levels of MCP-1, IL-6, and IL-8 can be used to identify individuals at risk of post-operative complications immediately after liver surgery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Bilirubin / blood*
  • Cytokines / blood*
  • Female
  • Humans
  • Liver / metabolism*
  • Liver / surgery
  • Liver Diseases / blood*
  • Liver Diseases / surgery
  • Male
  • Middle Aged
  • Postoperative Period
  • Preoperative Period
  • Reperfusion Injury / blood
  • Time Factors

Substances

  • Cytokines
  • Bilirubin