Early Expression of Pro- and Anti-Inflammatory Cytokines in Left Ventricular Assist Device Recipients With Multiple Organ Failure Syndrome

Raffaele Caruso, Salvatore Trunfio, Filippo Milazzo, Jonica Campolo, Renata De Maria, Tiziano Colombo, Marina Parolini, Aldo Cannata, Claudio Russo, Roberto Paino, Maria Frigerio, Luigi Martinelli (+1 others)
2010 ASAIO journal (1992)  
To assess whether the combined evaluation of total Sequential Organ Failure Assessment (t-SOFA) score and pro-and anti-inflammatory cytokine profiles early after left ventricular assist device (LVAD) implant discriminates patients at high risk for multiple organ failure syndrome (MOFS) in the first month post-LVAD, we analyzed plasma interleukin (IL)-6, IL-8, IL-10, IL-1ra, IL-1␤, tumor necrosis factor-␣ (TNF-␣), and urine neopterin levels before (day 0) and at 4 hours, 1, 3, 7, 14, and 30 days
more » ... 7, 14, and 30 days after LVAD implant in 23 recipients. Eight patients died of MOFS between days 7 and 30 (nonsurvivors). At preimplant, only blood urea nitrogen and age were higher in nonsurvivors than survivors. At 4 hours, IL-8, IL-10, and IL1-ra levels were higher in nonsurvivors than in survivors; t-SOFA was also higher and peaked on day 3 in nonsurvivors. Only IL-8 levels on day 1 were significantly associated with a t-SOFA >10 on day 3 (odds ratio 1.10, 95% confidence interval 1.01-1.21, p ‫؍‬ 0.04). Neopterin, marker of monocyte activation, increased significantly only in nonsurvivors (p < 0.001). These findings suggest that an activated inflammatory system soon after LVAD implant is implicated in MOFS development. Early monitoring of inflammatory mediators and t-SOFA score may be a valuable tool for outcome prediction in LVAD recipients. ASAIO Journal 2010; 56:313-318.
doi:10.1097/mat.0b013e3181de3049 pmid:20445439 fatcat:yf2km2ncmnat3hvsvmaefz2voe