The role of tumor necrosis factor in allograft rejection: I. evidence that elevated levels of tumor necrosis factor-alpha predict rejection following orthotopic liver transplantation

David K. Imagawa, J. Michael Millis, Kim M. Olthoff, Leslie J. Derus, David Chia, Lee R. Sugich, Miyuki Ozawa, Roy A. Dempsey, Yuichi Iwaki, Patricia J. Levy, Paul I. Terasaki, Ronald W. Busuttil

Research output: Contribution to journalArticlepeer-review

142 Scopus citations

Abstract

Plasma levels of tumor necrosis factor-alpha were measured in 50 adult patients following orthotopic liver transplantation. The mean (±SEM) plasma concentration of TNF-a was significantly higher in patients experiencing a rejection episode (941α83 pg/ml) than in those with a stable clinical course (240±6 pg/ml; P=0.004). Peak levels of TNF-α were usually found at the time of clinically diagnosed rejection, although elevated levels were observed 1-2 days earlier. First-week peak TNF-α levels were significantly higher in patients who suffered graft loss (2146±788 pg/ml) than in those who were discharged from the hospital without clinical evidence of rejection (581±93 pg/ml; P=0.004). TNF-α levels were not correlated with white blood cell count (r2=0.004), cyclosporine levels (0.01), serum creatinine (0.002), serum bilirubin (0.05), serum SGOT (0.03), or SGPT (0.05). TNF-a levels were not elevated in four cases of viral hepatitis occurring after transplantation. We conclude that circulating levels of TNF-α are elevated during liver allograft rejection and may precede clinical manifestations. First-week TNF-α levels are also useful predictors of long-term graft outcome. Further investigation is required to determine whether this monokine is important in the actual pathogenesis of allograft rejection.

Original languageEnglish (US)
Pages (from-to)219-225
Number of pages7
JournalTransplantation
Volume50
Issue number2
DOIs
StatePublished - Aug 1990

ASJC Scopus subject areas

  • Transplantation

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