J Korean Med Sci.  2011 Oct;26(10):1333-1338. 10.3346/jkms.2011.26.10.1333.

Comparison of the Child-Turcotte-Pugh Classification and the Model for End-stage Liver Disease Score as Predictors of the Severity of the Systemic Inflammatory Response in Patients Undergoing Living-donor Liver Transplantation

• Hong SH
• Kim JE
• Cho ML
• Heo YJ
• Choi JH
• Choi JH
• Lee J

• KMID: 1785992
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1333

Abstract

The aim of this study was to evaluate and compare the Child-Turcotte-Pugh (CTP) classification system and the model for end-stage liver disease (MELD) score in predicting the severity of the systemic inflammatory response in living-donor liver transplantation patients. Recipients of liver graft were allocated to a recipient group (n = 39) and healthy donors to a donor group (n = 42). The association between the CTP classification, the MELD scores and perioperative cytokine concentrations in the recipient group was evaluated. The pro-inflammatory cytokines measured included interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha; the anti-inflammatory cytokines measured included IL-10 and IL-4. Cytokine concentrations were quantified using sandwich enzyme-linked immunoassays. The IL-6, TNF-alpha, and IL-10 concentrations in the recipient group were significantly higher than those in healthy donor group patients. All preoperative cytokine levels, except IL-6, increased in relation to the severity of liver disease, as measured by the CTP classification. Additionally, all cytokine levels, except IL-6, were significantly correlated preoperatively with MELD scores. However, the correlations diminished during the intraoperative period. The CTP classification and the MELD score are equally reliable in predicting the severity of the systemic inflammatory response, but only during the preoperative period.

Keyword

Child-Turcotte-Pugh Classification; Cytokines; Living-Donor Liver Transplantation; Model for End-Stage Liver Disease Score

MeSH Terms

Adult
Cytokines/*blood
Female
Humans
Interleukin-10/blood
Interleukin-1beta/blood
Interleukin-4/blood
Interleukin-6/blood
Kidney Failure, Chronic/*classification/*surgery
Liver/pathology
*Liver Transplantation
Living Donors
Male
Middle Aged
Predictive Value of Tests
Severity of Illness Index
Systemic Inflammatory Response Syndrome/*diagnosis
Treatment Outcome
Tumor Necrosis Factor-alpha/blood

Figure

• 

  Fig. 1 Comparison of preoperative cytokine concentrations between groups. The box plots show the median (line in the middle of the box), interquartile range (box), and 10th and 90th percentiles (whiskers). *P < 0.05 versus donor group.

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