| ObjectiveAt present,the best treatment for patients suffering from end-stage organ failure is to transplant the corresponding healthy organ.For example,India is the second largest organ transplant country next to the mainland.During the six years of data monitoring from 2013 to 2018,a total of 49,155 cases of organ transplantation were reported.In addition to the living donors of kidney and liver,which were 6 times and 2 times of brain-dead donors respectively,the donors of heart,lung,pancreas and small intestine transplantation were all brain-dead patients.There is a strong link between brain death and heart,lung,pancreas,small intestine,liver and kidney transplants.Compared with healthy people,the vast majority of brain-dead patients have drug use,hypoxia,acute malnutrition,trauma,massive glucose supplement and other experiences,which will cause primary metabolic dysfunction,heart rate imbalance,immune balance imbalance in the organs of brain-dead patients,seriously affecting the success rate of recipients after transplantation.Up to now,organ transplant donors except kidneys are basically from brain dead patients,and the ultimate goal of long-term survival of organ transplantation grafts has not been realized.Although early immune-mediated injury is the main cause of graft dysfunction and failure,the influence of inflammatory factors should not be ignored.Trauma and critical illness were significantly correlated with the occurrence of inflammation,and the level of inflammatory markers was correlated with the survival rate of organ transplant recipients.In organ transplantation,brain damage and death of the donor significantly reduce graft function and increase the likelihood of rejection.The physiological and biochemical indexes of brain-dead donor patients and organ transplant recipients were included in this study.Prior to organ acquisition and transplantation,relevant immunological and serum collection was performed,organ allocation was tracked,and relevant data of organ recipients were collected and analyzed,and relevant cytokines were measured.Immediate graft function was described as correlated with long-term graft and patient survival.The correlation between donor inflammatory biomarkers(IL-2,IL-4,IL-6,IL-10,IL-17 A,IFN-γ,and TNF-α)and immediate graft function indicators,such as DGF,was analyzed.Finally,the predictive effect of inflammatory biomarkers on transplantation outcomes was explored to determine whether inflammatory biomarkers can be used as independent predictors of organ function loss.MethodsClinical data of brain-dead donor patients and organ transplant recipients obtained from XX Hospital of XX University from November 2021 to November2022 were retrospectively analyzed.According to the data,the levels of IL-2,IL-4,IL-6,IL-10,IL-17 A,IFN-γ and TNF-α of the donor were correlated with the same indicators of healthy donors.After screening out the different inflammatory markers,Different inflammatory markers were correlated with donor age(years),height(cm),body weight(kg),BMI(kg/㎡),body surface area,white blood cells,HLA mismatch number,plasma HBA1 c,hot ischemia time(min),cold ischemia time(h),blood type.Inspection index: Total protein,albumin,hemoglobin,BNP,PT,APPT,blood urea,blood creatinine,blood PH,urine PH,urine specific gravity,urine occult blood,urine protein,urine protein/creatinine,serum potassium ion,serum sodium ion,serum chloride ion,serum bicarbonate,serum calcium ion,serum magnesium ion,serum inorganic phosphorus,blood glucose,urine sugar,urine red blood cells,urine white blood cells,urine Epithelial cells,urinary physiological tube type,urinary bacteria,blood uric acid,glomerular filtration,serum cystatin C,IL2,IL4,IL6,IL10,IL-17 A,IFN-γ,TNF-αwere associated.At the same time,association analysis was conducted between differential inflammatory markers and basic indicators of organ transplant recipients,and the association between differential inflammatory markers of donors was analyzed.The association between inflammatory markers and the incidence of post-transplant complications was analyzed through the correlation between the differential inflammatory markers and the continuous measures of the organ transplant recipient.The basic indicators of transplant recipients are detailed below.Statistical software SPSS 13.0 was used for statistical analysis.According to the type of data,expressed as mean ±standard deviation(SD).Variables with normal distribution were compared with unidirectional unpaired T-test,and variables with non-normal distribution were compared with Mann-Whitney U test.Categorical variables were compared using chi-square tests or Fisher exact tests.Spearman correlation is used to study the correlation of continuous variables.ResultsThere were no significant differences in IL-2,IL-4,IL-17 A,IFN-γ and TNF-αin inflammation markers between brain dead donors and healthy subjects,and IL-6 and IL-10 in inflammation markers of brain-dead donors were significantly higher than those of healthy subjects.There was a significant positive correlation between IL-6,the inflammatory marker of the donor,and the hemoglobin level of the donor,and a significant negative correlation between IL-6 and the physiological urinary duct type of the donor;The inflammatory marker IL-10 of the transplanted donor was positively correlated with the level of leukocyte,hemoglobin and urine epithelial cells.The donor inflammatory markers IL-6 and IL-10 were significantly correlated with urinary p H,urinary specific gravity,serum creatinine,serum cystatin C,glomerular filtration rate,and urinary volume on some days after surgery,as shown in Result 3.There was a significant positive correlation between IL-6 and IL-10 levels in brain dead donors,but there was a specific correlation between specific indicators.The levels of IL-6 and IL-10 in brain dead donors have different effects on postoperative serum urea levels,the levels of IL-6 and IL-10 in brain dead donors have different effects on postoperative serum urea levels,and the levels of IL-6 and IL-10 in brain dead donors have different effects on postoperative serum potassium levels.The levels of IL-6 and IL-10 in brain dead donors had the same effect on postoperative serum BNP levels.The serum IL-10 level of brain-dead donors was highly positively correlated with DGF symptoms of the recipient,but the serum IL-6 level of brain-dead donors was not significantly correlated with DGF.Serum IL-10 levels in brain dead donors may predict whether the recipient has DGF complications after transplantation.ConclusionsIL-6 and IL-10 in inflammatory biomarkers can predict the physical function indicators of the recipient after transplantation,such as urine p H,urine specific gravity,serum creatinine,serum cystatin C,glomerular filtration rate,and urine volume level.The higher the IL-10 level of the brain-dead donor,the more likely the recipient to have DGF complications after transplantation. |
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