The Ratio of Plasma Interleukin-18 Is a Sensitive Biomarker for Acute Kidney Injury After Liver Transplantation

Background. Acute kidney injury (AM) is common after liver transplantation (OLT) and is associated with high morbidity and mortalfty. Previous studies have shown that interleukin-18 (IL-18) levels are associated with AKI. The purpose of this study was to determine whether plasma IL-18 levels were early predictors for AKI after liver transplantation. Methods. Plasma samples were obtained from 26 patients who underwent OLT at induction of anesthesia (T1), 1 hour after the surgical incision (T2), the time of reperfusion (T3), as well as 1 (T4), 2 (T5), and 4 hours (T6) after reperfusion. Samples were also obtained at 24 hours after surgery (T7). The AM criteria were taken according to the Acute Kidney Injury Network criteria. Results. Twelve patients (46%) developed AM after OLT. The area under the receiver operating curve of plasma IL-18 concentrations (T4/T1) to predict AM occurrence was 0.842 at T5, 0.905 at T6, 0.726 at T7, and 0.726 at T5 to T7. Conclusion. Plasma IL-18 concentrations taken 1 hour after reperfusion were predictive of AM. Therefore, changing IL-18 ratio may be an early predictor for AM after OLT.