Elevated Levels of Interleukin-8 in Donor Lungs Is Associated with Early Graft Failure after Lung Transplantation
- 1 January 2001
- journal article
- research article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 163 (1), 259-265
- https://doi.org/10.1164/ajrccm.163.1.2005093
Abstract
Increased levels of the neutrophil chemokine interleukin (IL)-8 in the lungs of severe trauma patients can predict subsequent development of acute respiratory distress syndrome. Because the lungs of brain-dead organ donors can contain high levels of IL-8, we hypothesized that this may predispose to early graft failure in the recipient after lung transplantation. Twenty-six organ donors prospectively satisfying clinical criteria for lung donation underwent bronchoalveolar lavage and lung biopsy to determine the effect of neutrophil infiltration and IL-8 expression in the donor lung on graft function and survival in 26 respective recipients after lung transplantation. Nine recipients developed severe graft dysfunction, of whom six subsequently died (median survival: 24 d [range: 5 to 39 d]); all others survived beyond 6 mo. The IL-8 signal in the donor lung correlated with the percent neutrophils in bronchoalveolar lavage fluid (BALF) before implantation (42.4 ± 7.24 [mean ± SE]%, p = 0.03) and with the degree of impairment in graft oxygenation after implantation (p = 0.01). An increased level of IL-8 in the donor BALF was associated with the development of severe early graft dysfunction (p = 0.027) and with early recipient mortality (p = 0.0034). Use of donor lungs with high IL-8 levels is associated with a poor prognosis after lung transplantation. Attenuating the donor's inflammatory response before organ retrieval may improve early outcome after lung transplantation, and help maximize lung use from the existing donor pool.This publication has 29 references indexed in Scilit:
- Enhanced pulmonary inflammation in organ donors following fatal non-traumatic brain injuryThe Lancet, 1999
- A comparison of mini-bronchoalveolar lavage and blind-protected specimen brush sampling in ventilated patients with suspected pneumoniaJournal of Critical Care, 1998
- EFFECTS OF EXPLOSIVE BRAIN DEATH ON CYTOKINE ACTIVATION OF PERIPHERAL ORGANS IN THE RAT1Transplantation, 1998
- Acute Lung Injury in Isolated Traumatic Brain InjuryNeurosurgery, 1997
- Lung transplantation.American Journal of Respiratory and Critical Care Medicine, 1997
- Lung preservation: The importance of endothelial and alveolar type II cell integrityThe Annals of Thoracic Surgery, 1996
- Blood levels of cytokines in brain-dead patients: Relationship with circulating hormones and acute-phase reactantsMetabolism, 1995
- The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination.American Journal of Respiratory and Critical Care Medicine, 1994
- Prevention of lung reperfusion injury in rabbits by a monoclonal antibody against interleukin-8Nature, 1993
- Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groupsThe Lancet, 1993