The Association of Promoter Gene Polymorphisms of the Tumor Necrosis Factor-α and Interleukin-10 with Severity of Lactic Acidosis During Liver Transplantation Surgery

Background. Orthotopic liver transplantation (OLT) is a major operation, causing cytokine release and other inflammatory responses that can contribute to postreperfusion syndrome occurrence. During the systemic inflammatory response syndrome, increased lactate levels result from excessive cytokine production despite normal oxygen delivery and carbohydrate metabolism. The goal of the study was to determine the relationship between genetic polymorphisms in interleukin (IL)-10 (-1082G/A) or tumor necrosis factor (TNF)-alpha (-376 G/A) and lactate levels in patients during OLT surgery. Patients and Methods. This prospective observational study in 40 consecutive adult patients who underwent OLT documented lactic acid levels at 5 times: Immediately after induction of anesthesia, at the end of the pre-anhepatic phase, at the end of the anhepatic phase, 1 hour after reperfusion, and at the end of surgery. Polymerase chain reaction (PCR; RFLP methodology) was used to examine IL-10 (-1082G/A) and TNF-alpha (-376 G/A) gene polymorphisms. Results. Carriers of the IL-10/TNF-alpha genotype combination GG/GG showed significantly different changes in lactate levels at 1 hour after reperfusion and at the end of surgery. Lactate levels were significantly higher among patients heterozygous for TNF-alpha (AG genotype) compared with patients homozygous for TNF-alpha (GG genotype) at same times. In contrast, there was no significant difference among IL-10 polymorphic genotypes (-1082G/A). Conclusion. Genetic factors play a role in the development of lactic acidosis after OLT. IL-10 (-1082G/A) and TNF-alpha (-376 G/A) gene polymorphisms could influence the variability of lactate levels after liver transplantation surgery.