Immediate post-operative broncho-alveolar lavage IL-6 and IL-8 are associated with early outcomes after lung transplantation
Immediate post-operative broncho-alveolar lavage IL-6 and IL-8 are associated with early outcomes after lung transplantation
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DOI：
10.1111/ctr.13219
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发表时间：
2018-04-01
影响因子：
2.1
通讯作者：
Vos, Robin
中科院分区：
文献类型：
--
作者：
Verleden, Stijn E.;Martens, An;Vos, Robin
简介：先前的研究表明，在肺移植之前或之后不久，细胞因子和趋化因子水平的增加与移植后的结果相关。然而，大多数使用小型患者队列，重点关注 1 个分子和 1 个结果。在一个大型单中心队列中，我们研究了术后立即支气管肺泡灌洗 (BAL) 表达的 IL-6 和 IL-8 对多个关键结局的预测价值，包括 PGD、CLAD、移植物存活以及几个次要结局。 材料和方法：所有接受第一次肺移植的患者均在移植后 48 小时内进行了常规支气管镜检查。通过 ELISA 测定 BAL 中的 IL-6 和 IL-8 蛋白水平。结果：总共纳入 336 名患者。移植后 24 小时内测得的高 IL-6 水平与入住 ICU 的时间较长和出院时间较长有关； 3 级 PGD 患病率增加。24 小时内测量的 IL-8 水平升高与 PGD3、更多 ECMO 使用、更高的供体 PaO 2、更年轻的供体年龄相关，但与其他短期或长期结果无关。移植后 24 至 48 小时内测量的 IL-6 和 IL-8 与任何结果参数均无关。结论：移植后 24 小时内受者 BAL IL-6 和 IL-8 与 PGD3 发生率增加相关。
Introduction: Previous studies demonstrated that increased cytokine and chemokine levels, either shortly before or after lung transplantation, were associated with post-transplant outcome. However, small patient cohorts were mostly used, focusing on 1 molecule and 1 outcome. In a large single-center cohort, we investigated the predictive value of immediate post-operative broncho-alveolar lavage (BAL) expression of IL-6 and IL-8 on multiple key outcomes, including PGD, CLAD, graft survival, as well as several secondary outcomes.Material and methods: All patients undergoing a first lung transplant in whom routine bronchoscopy with BAL was performed during the first 48 hours post-transplantation were included. IL-6 and IL-8 protein levels were measured in BAL via ELISA.Results: A total of 336 patients were included. High IL-6 levels measured within 24 hours of transplantation were associated with longer time on ICU and time to hospital discharge; and increased prevalence of PGD grade 3. Increased IL-8 levels, measured within 24 hours, were associated with PGD3, more ECMO use, higher donor paO 2, younger donor age, but not with other short- or long-term outcome. IL-6 and IL-8 measured between 24 and 48 hours of transplantation were not associated with any outcome parameters.Conclusion: Recipient BAL IL-6 and IL-8 within 24 hours post-transplant were associated with an increased incidence of PGD3.