Objective To explore the changes of serum cytokines including endotoxin, TNF-α, IL-18, IL-10, IL-4, NO, SVCAM-1 and SICAM-1 in the peri-operative liver transplantation of liver failure patients after artificial liver therapy (plasma exchange combined with continuous veno-venous hemodiafiltration, PE+CVVHDF), and to investigate the short-term prognosis of artificial liver therapy in the treatment of liver failure patients and its possible mechanism. Methods We selected 54 liver failure patients in peri-operative liver transplantation. Twenty-three of them were treated with the artificial liver support system (ALSS) for a total of 61 times (ALSS group), and 31 patients were treated with the routine therapy (routine therapy group). Serum cytokines were determined before and after the treatment. Clinical outcome and changes of serum cytokines including IL-10, IL-4, IL-18, TNF-α, endotoxin, NO, SVCAM-1 and SICAM-1 were analyzed. Results The effectiveness rate in a short period of time was 65.22% in ALSS group, and was 32.26% in routine therapy group (P<0.01). In ALSS group after the treatment, IL-4, IL-18, TNF-α, VCAM-1, SICAM-1, NO and endotoxin decreased significantly (P<0.01), but the change of serum IL-10 was insignificant (P>0.05), as compared with those before the treatment. In routine therapy group after the treatment, however, changes of serum IL-4, IL-18, TNF-α, VCAM-1, SICAM-1, NO, endotoxin and IL-10 were insignificant (P>0.05), as compared with those before the treatment. In effective patients by ALSS or routine therapy, serum IL-4, IL-18, TNF-α, VCAM-1, SICAM-1, NO and endotoxin decreased, predominantly in patients treated with ALSS. In ineffective patients after the treatments, however, these serum contents showed no changes. Conclusion ALSS significantly reduces the levels of serum IL-4, IL-18, TNF-α, VCAM-1, SICAM-1, NO, and endotoxin, alleviates the hepatocyte injury due to inflammatory reaction, and improves the short-term prognosis in liver failure patients. Frequent monitoring serum cytokines will provide useful information for the treatment of liver failure patients.
Key words
Liver failure /
Cytokine /
Endotoxin
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