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British Journal of Anaesthesia, Vol 79, Issue 3 338-341, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

Changes in inflammatory mediators during orthotopic liver transplantation

M. C. Bellamy, H. F. Galley and N. R. Webster
Intensive Care Unit, St James's University Hospital, Leeds LS9 7TF; Academic Unit of Anaesthesia and Intensive Care, Institute of Medical Sciences, University of Aberdeen, Aberdeen

Transplantation is associated with an inflammatory rejection response. Graft reperfusion causes typical haemodynamic and biochemical responses. In this study we have investigated the relationship between these haemodynamic responses and changes in circulating inflammatory mediators after graft reperfusion in 10 consecutive patients undergoing orthotopic liver transplantation. After reperfusion, systemic vascular resistance index decreased (P = 0.011) and cardiac index increased (P = 0.038). These characteristic haemodynamic changes of the reperfusion syndrome were accompanied by global increases in cytokine concentrations. Plasma concentrations of leukotrienes decreased, while thromboxane B2 and platelet activating factor remained increased throughout. Reperfusion-mediated changes in inflammatory mediators may account for the haemodynamic disturbance.
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