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. 1994 Apr 15;57(7):1037-41.
doi: 10.1097/00007890-199404150-00009.

Evaluation of sequential serum interleukin-6 levels in liver allograft recipients

Y Kita  1 , Y Iwaki, A J Demetris, T E Starzl
Affiliations

Evaluation of sequential serum interleukin-6 levels in liver allograft recipients

Y Kita et al. Transplantation. .

Abstract

Control serum levels of IL-6 measured by ELISA in 30 healthy blood donors or volunteers were 18 +/- 34 pg/ml (mean +/- SD). Pretransplant serum levels of IL-6 in 169 adult candidates for liver transplantation were significantly higher than control in those with fulminant hepatitis (203 +/- 232 pg/ml), alcoholic cirrhosis (116 +/- 257 pg/ml), and hepatocellular carcinoma (82 +/- 105 pg/ml). With these data as background, plasma or serum levels of IL-6 were monitored in 24 adult patients after first OLT and correlated with the clinical courses and the histopathological diagnosis of rejection. Serum or plasma levels of IL-6 decreased after transplantation regardless of pretransplant value. Four patients with infection subsequently developed continuously high IL-6 values. In the 20 of 24 patients who did not have infection, significantly higher levels of IL-6 were consistently found 0-4 days before histopathological diagnosis of rejection (131 +/- 78 pg/ml) compared with significantly lower values in patients without rejection episodes (40 +/- 21 pg/ml). The elevations of IL-6 were spike shaped, did not correlate well with the histopathological grades of rejection, and were highly responsive to augmented immunosuppression. These 20 cases were classified as: group 1, no spikes of IL-6 after liver transplantation; group 2, single spike of IL-6 after liver transplantation; and group 3, multiple spikes of IL-6 after liver transplantation. The combined early and late graft loss of each group was 0% (group 1), 25% (group 2), and 67% (group 3). We conclude that daily monitored serum or plasma IL-6 levels can be a good premonitor of liver allograft rejection and also a useful predictor of long-term graft outcome.

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Figures

Figure 1
Figure 1
Serum IL-6 before and after first liver transplantation in 24 recipients.
Figure 2
Figure 2
Serum or plasma IL-6 monitoring in 4 representative liver transplant recipients. Arrows shows the time of biopsy or drug administration. (A) Group 1: case EM, alcoholic cirrhosis and hepatocellular carcinoma, 64-year-old man; (B) group 2: case EF, cryptogenic cirrhosis, 61-year-old woman; (C) group 3: case DM, cryptogenic cirrhosis, 48-year-old man; (D) group 4: case TM, postnecrotic cirrhosis due to hepatitis B, 56-year-old man.
See this image and copyright information in PMC

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