BACKGROUND: Post-lung transplant reperfusion edema (PLTRE) and its more severe form, primary graft failure (PGF), occur in 10% to 60% of lung transplant recipients. We hypothesized that PLTRE and PGF would be associated with an elevated proinflammatory cascade and that the allograft would be the source of cytokine appearance in the circulation. METHODS: Pulmonary arterial and systemic arterial samples were obtained at baseline and at 4, 8, and 24 hours after reperfusion. Post-lung transplant reperfusion-edema and PGF were defined as PaO2/FiO2 less than 300 with a mild or moderate infiltrate, or less than 200 with a severe infiltrate and ventilator dependence after 72 hours, respectively. Tumor necrosis factor alpha (TNFalpha), interleukin (IL)-6, IL-8, and IL-10 concentrations were determined by immunoassay. RESULTS: Fifteen single and 6 bilateral lung recipients were studied. Six (29%) had PLTRE and 4 (19%) had PGF; these patients had an overall elevation in plasma IL-6, IL-8, and IL-10 concentrations (all p < 0.05). Subgroup analysis revealed a significantly greater elevation in IL-6, IL-8, and IL-10 levels in PGF patients (all p < 0.01) versus PLTRE. In the PGF group, TNFalpha and IL-10 concentrations were significantly greater in the systemic versus the pulmonary arterial samples (p < 0.05). CONCLUSIONS: Patients with PLTRE and PGF exhibited graded increases in IL-6, IL-8, and IL-10 concentrations. The PGF patients had higher TNFalpha and IL-10 systemic arterial concentrations overall, consistent with the allograft being a source of this cytokine production.
BACKGROUND: Post-lung transplant reperfusion edema (PLTRE) and its more severe form, primary graft failure (PGF), occur in 10% to 60% of lung transplant recipients. We hypothesized that PLTRE and PGF would be associated with an elevated proinflammatory cascade and that the allograft would be the source of cytokine appearance in the circulation. METHODS: Pulmonary arterial and systemic arterial samples were obtained at baseline and at 4, 8, and 24 hours after reperfusion. Post-lung transplant reperfusion-edema and PGF were defined as PaO2/FiO2 less than 300 with a mild or moderate infiltrate, or less than 200 with a severe infiltrate and ventilator dependence after 72 hours, respectively. Tumor necrosis factor alpha (TNFalpha), interleukin (IL)-6, IL-8, and IL-10 concentrations were determined by immunoassay. RESULTS: Fifteen single and 6 bilateral lung recipients were studied. Six (29%) had PLTRE and 4 (19%) had PGF; these patients had an overall elevation in plasma IL-6, IL-8, and IL-10 concentrations (all p < 0.05). Subgroup analysis revealed a significantly greater elevation in IL-6, IL-8, and IL-10 levels in PGFpatients (all p < 0.01) versus PLTRE. In the PGF group, TNFalpha and IL-10 concentrations were significantly greater in the systemic versus the pulmonary arterial samples (p < 0.05). CONCLUSIONS:Patients with PLTRE and PGF exhibited graded increases in IL-6, IL-8, and IL-10 concentrations. The PGFpatients had higher TNFalpha and IL-10 systemic arterial concentrations overall, consistent with the allograft being a source of this cytokine production.
Authors: Jonathan P Singer; Joshua M Diamond; Cynthia J Gries; Jamiela McDonnough; Paul D Blanc; Rupal Shah; Monica Y Dean; Beverly Hersh; Paul J Wolters; Sofya Tokman; Selim M Arcasoy; Kristy Ramphal; John R Greenland; Nancy Smith; Pricilla Heffernan; Lori Shah; Pavan Shrestha; Jeffrey A Golden; Nancy P Blumenthal; Debbie Huang; Joshua Sonett; Steven Hays; Michelle Oyster; Patricia P Katz; Hilary Robbins; Melanie Brown; Lorriana E Leard; Jasleen Kukreja; Matthew Bacchetta; Errol Bush; Frank D'Ovidio; Melanie Rushefski; Kashif Raza; Jason D Christie; David J Lederer Journal: Am J Respir Crit Care Med Date: 2015-12-01 Impact factor: 21.405
Authors: David J Hall; Maher Baz; Michael J Daniels; Edward Denmark Staples; Charles T Klodell; Lyle L Moldawer; Thomas M Beaver Journal: Interact Cardiovasc Thorac Surg Date: 2012-07-19
Authors: Michaela R Anderson; Jayaram K Udupa; Ethan Edwin; Joshua M Diamond; Jonathan P Singer; Jasleen Kukreja; Steven R Hays; John R Greenland; Anthony Ferrante; Matthew Lippel; Tatiana Blue; Amika McBurnie; Michelle Oyster; Laurel Kalman; Melanie Rushefski; Caiyun Wu; Gargi Pednekar; Wen Liu; Selim Arcasoy; Joshua Sonett; Frank D'Ovidio; Matthew Bacchetta; John D Newell; Drew Torigian; Edward Cantu; Donna L Farber; Jon T Giles; Yubing Tong; Scott Palmer; Lorraine B Ware; Wayne W Hancock; Jason D Christie; David J Lederer Journal: J Heart Lung Transplant Date: 2019-08-10 Impact factor: 10.247
Authors: Jonathan P Singer; Eric R Peterson; Mark E Snyder; Patricia P Katz; Jeffrey A Golden; Frank D'Ovidio; Matthew Bacchetta; Joshua R Sonett; Jasleen Kukreja; Lori Shah; Hilary Robbins; Kristin Van Horn; Rupal J Shah; Joshua M Diamond; Nancy Wickersham; Li Sun; Steven Hays; Selim M Arcasoy; Scott M Palmer; Lorraine B Ware; Jason D Christie; David J Lederer Journal: Am J Respir Crit Care Med Date: 2014-11-01 Impact factor: 21.405
Authors: S A Hoffman; L Wang; C V Shah; V N Ahya; A Pochettino; K Olthoff; A Shaked; K Wille; V N Lama; A Milstone; L B Ware; J Orens; A Weinacker; E Demissie; S Bellamy; S M Kawut; W W Hancock; J D Christie Journal: Am J Transplant Date: 2008-12-15 Impact factor: 8.086
Authors: Carolyn S Calfee; Marie M Budev; Michael A Matthay; Gwynne Church; Sandra Brady; Tokujiro Uchida; Akitoshi Ishizaka; Abigail Lara; Justin L Ranes; Malcom M deCamp; Alejandro C Arroliga Journal: J Heart Lung Transplant Date: 2007-07 Impact factor: 10.247