Tumor necrosis factor-α in liver transplantation and resection: No evidence for a key role in ischemia-reperfusion injury

Experimental studies have shown that liver ischemia-reperfusion induces Kupffer cell activation and tumor necrosis factor-α (TNFα) release. The aim of this work was to determine whether severe hepatic ischemia and subsequent reperfusion triggers TNFα release in man. Serum TNFα was measured before and 3, 10, 30, 60, 120 min after revascularization and postoperatively at day 1 and 2 in 11 patients with orthotopic liver transplantation (group 1 and 4 patients with liver resection with vascular occlusion (group 2). In group 1, TNFα levels decreased during the first few minutes of reperfusion, then increased slightly to peak at 120 min (40 ± 13 pg/ml). Primary non-function occurred in 1 patient in whom low peroperative levels of TNFα levels were measured. In group 2, no significant changes in TNFα levels were observed. These data, in a small number of patients: (a) show that hepatic ischemia reperfusion does not result in major TNFα production; (b) do not support a primary pathogenic role for TNFα in damage after ischemia-reperfusion in humans.