Changes of urinary tripsin inhibitor in blood and urine, as well as serum cytokines in living related liver transplantation

Background: Living related liver transplantation induces the production of many inflammatory and anti-inflammatory cytokines. Urinary tripsin inhibitor (UTI) is produced in the liver and well-known as one of the markers of surgical stress. Methods: To clarify the significance of UTI in blood and urine and serum cytokines in living related liver transplantation, we examined the changes of UTI, polymorphonuclear elastase (PMNE), interleukin (IL)-6, IL-1 ra and IL-10 perioperatively. Results: UTI in blood increased gradually after operation. It increased from 5.2± 2.2 U · ml^-1 at the end of operation to 19.4±7.5 U · ml^-1 on the 10 th postoperative day (POD). Similarly, UTI in urine increased after operation and the peak was on the 7 th POD. Cytokines including IL-6, IL-1 ra and IL-10 showed similar changes in general gastrointestinal surgery, but the peak values in liver transplantation were lower. Conclusion: These results demonstrate that the recovery of the transplanted liver function require certain time after operation and UTI in urine could be an important marker whether the liver is working or not. The immunosuppressive drugs, like steroid, administered during and after operation would suppress the production of cytokines.