Practical Journal of Organ Transplantation(Electronic Version) ›› 2013, Vol. 1 ›› Issue (5): 271-275.DOI: 10.3969/j.issn.2095-5332.2013.05.001

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Prognostic values of serum soluble interleukin-2 receptor and biliary interleukin-6 in early acute rejectionand infection after liver transplantation

GAO Si-nan，MA Ning，LIU Lei，LIU Yi-he，YU Li-xin. 
  

  1. Tianjin First Central Hospital，Tianjin Key Laboratory of Organ Transplantation，Tianjin 300192，China
  • Online:2013-09-20 Published:2021-04-19

血清可溶性白细胞介素-2 受体和胆汁白细胞介素-6 水平监测在肝移植术后早期急性肾功能衰竭患者免疫抑制剂调节和感染预测中的应用

高思楠，马宁，刘蕾，刘懿禾，于立新   

  1. 天津市第一中心医院器官移植中心移植重症监护病房，天津市器官移植重点实验室，天津 300192
  • 基金资助:

    国家高技术研究发展计划（863）项目（2012AA021001）；

    卫生部重点实验室项目；天津市医药卫生科技基金（09KZ30）

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Abstract:

Objective To detect the prognostic values of serum soluble interleukin-2 receptor（sIL-2R）and biliary interleukin-6（IL-6）in acute rejection and infection after orthotopic liver transplantation（OLT），and tobuild a reasonable immunosuppressant strategy for patients with acute renal failure（ARF）after OLT. Methods 30patients with ARF after liver transplantation were selected as control with the routine immunosuppressant protocol.Serum sIL-2R and biliary IL-6 were monitored at post operation day（POD）1，3，5，7，9，11，14. Other 30patients with ARF after liver transplantation were in study group with reduced immunosuppressant. Serum sIL-2Rand biliary IL-6 were monitored at POD 1，3，5，7，9，11，14，based on which tacrolimus（
FK506）dosage wasadjusted. Acute rejection， infection and recovery of ARF were compared between two groups. Results Patientswith acute rejection had higher serum sIL-2R comparing with the stable patients（P ＜ 0.05）. Levels of sIL-2R andbiliary IL-6 in patients with infection were higher than those in stable patients（P ＜ 0.05）. The incidence of acuterejection of patients in study group with reduced immunosuppressant adjusted according to sIL-2R and biliary IL-6did not increase. Recovery time of ARF was shorter in study group than that in control group（days ：7.47±9.39 vs.16.15±12.67，P ＜ 0.05）. Conclusions Serum sIL-2R and biliary IL- 6 can be used as markers of early acuterejection and infection after liver transplantation. The incidence of acute rejection did not increase in patients withreduced FK506 dosage which could benefit the recovery of ARF.

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摘要：

目的 探讨血清可溶性白细胞介素-2 受体（sIL-2R）和胆汁白细胞介素-6（IL-6）水平监测在肝移植术后早期诊断急性排斥反应和感染中的意义，为肝移植术后急性肾衰竭（ARF）患者免疫抑制剂的应用提供合理的策略。方法 选择肝移植术后 ARF 患者作为研究对象。30 例对照组患者实施本中心以往制定的常规免疫抑制剂方案，动态监测术后第 1、3、5、7、9、11、14 天血清 sIL-2R 和胆汁
IL-6 水平的变化，作为 T 细胞活化的客观指标。30 例试验组患者在常规免疫抑制剂治疗方案基础上，减少他克莫司（FK506）用量，检测术后第 1、3、5、7、9、11、14 天血清 sIL-2R 和胆汁 IL-6 水平，以其变化趋势指导 FK506 剂量的调节。比较两组患者急性排斥反应、继发感染的发生率和肾功能恢复情况。结果 肝移植术后早期发生急性排斥反应时，患者血清 sIL-2R 水平较稳定组升高，组间差异有统计学意义（P ＜ 0.05）；继发感染时，患者血清 sIL-2R 和胆汁 IL-6 水平均较稳定组升高，组间差异有统计学意义
（P ＜ 0.05）。以血清 sIL-2R 和胆汁 IL-6 水平作为急性排斥反应风险指标的免疫抑制剂调节方案与以往的常规方案相比，患者术后急性排斥反应的发生率未见显著增加。试验组患者术后 ARF 持续时间较对照组缩短（天 ：7.47±9.39 比 16.15±12.67），组间差异有统计学意义（P ＜ 0.05）。结论 肝移植术后早期动态监测血清 sIL-2R 和胆汁 IL-6 水平可以作为急性排斥反应和感染的早期诊断指标 ；以血清 sIL-2R 为指标，监测急性排斥反应风险，进行个体化免疫抑制剂调节，未增加急性排斥反应的发生率 ；术后在常规免疫抑制剂方案基础上减少 FK506 用量对于患者肾功能的恢复具有促进作用。

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Practical Journal of Organ Transplantation(Electronic Version)
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