Predicting value of PDGF-BB combined with CLIF-COFs for the occurrence of ARDS in post-liver transplantation patients

Objective To investigate the role of cytokines combined with CLIF consortium organ failure score (CLIF-COFs) for predicting the occurrence of acute respiratory distress syndrome (ARDS) in for post-liver transplant for hepatitis B-related acute-on-chronic liver failure (HB-ACLF) patients. Methods From Jul. 2014 to Oct. 2017, there were 37 cases of HB-ACLF undergoing liver transplantation in Beijing YouAn Hospital, Capital Medical University. According to whether the patients happened ARDS or not, 37 cases were divided into ARDS group (n=9) and non-ARDS group (n=28). All patients′ plasma was prospectively collected immediately before liver transplantation and on the 1st, 3rd, 5th, 7th day post-liver transplantation. The serum levels of twenty-seven cytokines were determined by 200 LUMINEX liquid chip technology. Cytokines, CLIF-COFs, clinical and biochemical indexes were analyzed with logistic regression and the receiver operating characteristic(ROC) to confirm the correlation with ARDS post liver transplantation. Results There were significant differences between HB-ACLF patients between ARDS group and non-ARDS group in age and pre-transplant infection (P<0.05). The CLIF-COFs was higher in ARDS non-without than that in non-ARDS group (P=0.019). The serum levels of vascular endothelial growth factor and platelet-derived growth factor bb were lower but IL-6 was higher post transplantation in ARDS group. The COX analysis indicated that CLIF-COFs and post liver transplantation PDGF-BB were predictors of post-LT ARDS. The area under the receiver operating characteristic (AUROC) curves was 0.728 and 0.175, respectively. The area under the curve of the discriminatory power of CLIF-COFs combined with PDGF-BB was 0.913, and the maximum Youden index is 0.786. Conclusion CLIF-COFs combines with PDGF-BB can predict the occurrence of ARDS post-liver transplantation in HB-ACLF patients. Key words: Liver transplantation; Respiratory distress syndrome, adult; Cytokines; Platelet-derived growth factor BB; Acute-on-chronic liver failure