Effects Of Low-dose Ketamine On Plasma Concentration Of Cytokines During Orthotopic Liver Transplantation

Background: Early allograft rejection, infection and poor initial graft function may increase mortality of orthotopic liver transplantation(OLT). Tumor necrosis factor alpha (TNF-a) and interleukin(IL)-6 were believed to be related to postoperative rejection and infection. Cytokines regulate the immune and inflammatory response. Stress and trauma of surgery, excessive blood loss, persistent hypotension, in particular the anhepatic phase and subsequent ischemia-reperfusion injury cause inflammatory response which correlate with cytokine during orthotopic liver transplantation(OLT). Inadequately regulated cytokine production resulted from excessive inflammatory response maybe harmful to the body. Various anesthetics have been suggested to interfere with the immune system. It was reported that ketamine,as an traditional intravenous anesthetic, could attenuate production of cytokines.Objective: The purpose of this study was to investigate the trend of perioperative levels of TNF-a, IL-6 and IL-10 in plasma in patients undergoing liver transplantation, and evaluate the effects of low-dose ketamine on them. The correlation between postoperative complications and levels of cytokine were also discussed in this study. These observations maybe of value for more rational anesthetic protocol to depress the cytokine levels and decrease reperfusion injury.