Primary graft dysfunction (
PGD) after
lung transplantation causes significant morbidity and mortality. We aimed to determine the role of
cytokines and
chemokines in
PGD. This is a multicenter case-control study of
PGD in humans. A Luminex analysis was performed to determine plasma levels of 25
chemokines and
cytokines before and at 6, 24, 48 and 72 h following allograft reperfusion in 25 cases (grade 3
PGD) and 25 controls (grade 0
PGD).
Biomarker profiles were evaluated using a multivariable logistic regression and generalized estimating equations.
PGD cases had higher levels of
monocyte chemotactic protein-1 (MCP-1)/
chemokine CC motif
ligand 2 (CCL2) and
interferon (IFN)-inducible
protein (IP-10)/
chemokine CXC motif
ligand 10 (CXCL10) (both p < 0.05), suggesting recruitment of monocytes and effector T cells in
PGD. In addition,
PGD cases had lower levels of
interleukin (IL-13) (p = 0.05) and higher levels of IL-2R (p = 0.05). Proinflammatory
cytokines, including
tumor necrosis factor (
TNF)-alpha, and IFN-gamma decreased to very low levels after transplant in both
PGD cases and controls, exhibiting no differences between the two groups. These findings were independent of clinical variables including diagnosis in multivariable analyses, but may be affected by
cardiopulmonary bypass. Profound injury in clinical
PGD is distinguished by the upregulation of selected
chemokine pathways, which may useful for the prediction or early detection of
PGD if confirmed in future studies.