PDF(Pubmed)
Abstract：
Brain death triggers a systemic inflammatory response. Whether systemic inflammation is different in lung donors after brain- (DBD) or circulatory-death (DCD) is unknown, but this may potentially increase the incidence of primary graft dysfunction (PGD) after lung transplantation. We compared the plasma levels of interleukin (IL)-6, IL-8, IL-10 and TNF-α in BDB and DCD and their respective recipients, as well as their relationship with PGD and mortality after LT. A prospective, observational, multicenter, comparative, cohort-nested study that included 40 DBD and 40 DCD lung donors matched and their respective recipients. Relevant clinical information and blood samples were collected before/during lung retrieval in donors and before/during/after (24, 48 and 72 h) LT in recipients. Incidence of PGD and short-term mortality after LT was recorded. Plasma levels of all determined cytokines were numerically higher in DBD than in DCD donors and reached statistical significance for IL-6, IL-10 and IL-8. In recipients with PGD the donor\'s plasma levels of TNF-α were higher. The post-operative mortality rate was very low and similar in both groups. DBD is associated with higher systemic inflammation than DCD donors, and higher TNF-α plasma levels in donors are associated with a higher incidence of PGD.
摘要：
脑死亡引发全身性炎症反应。肺部供者脑后（DBD）或循环死亡（DCD）的全身性炎症是否不同尚不清楚，但这可能会增加肺移植后原发性移植物功能障碍（PGD）的发生率。我们比较了BDB和DCD及其各自接受者的血浆白细胞介素（IL）-6，IL-8，IL-10和TNF-α水平，以及它们与PGD和LT后死亡率的关系。一个潜在的，观察,多中心，比较,队列嵌套研究，包括40个DBD和40个DCD肺供体匹配和他们各自的接受者。在供体的肺取回之前/期间以及在受体的LT之前/期间/之后（24、48和72小时）收集相关的临床信息和血液样本。记录LT术后PGD的发生率和短期死亡率。所有测定的细胞因子的血浆水平在DBD中在数值上高于在DCD供体中,并且对于IL-6、IL-10和IL-8达到统计学显著性。在PGD患者中，供体的血浆TNF-α水平较高。两组的术后死亡率非常低且相似。与DCD供体相比，DBD与更高的全身性炎症相关，供体中更高的TNF-α血浆水平与更高的PGD发生率相关。
