Chemokine (C-X-C motif) ligand 11 levels predict survival in cirrhotic patients with transjugular intrahepatic portosystemic shunt.

Background & Aims Chemokines, such as CXCR3-ligands, have been identified to play an important role during hepatic injury, inflammation and fibrosis. While CXCL9is associated with survival in patients receiving transjugular intrahepatic portosystemic shunt(TIPS), the role of CXCL11in severe portal hypertension remains unknown. Methods CXCL11- levelswere measuredin 136 patients with liver diseases, and 63 healthy controls. In further 47 cirrhotic patients receiving TIPS, CXCL11 levelswere measuredin portal and hepatic veinsat TIPS insertion by cytometric bead array. CXCL11- levelswere measuredin 23 patients in cubitalvein and right atrium, whereas in 24 patients in portal and hepatic blood at an invasive reevaluation. Results CXCL11-levels were increased with the severity of liver fibrosis. CXCL11-levels from portal, hepatic and cubitalveins and right atriumshowed a highly significant correlation among each other in these patients. Furthermore, levels of CXCL11from the right atriumwere significantly higher than those from cubitalvein. Interestingly, patients with alcoholic cirrhosishad significantly lower CXCL11-levels, than other aetiologies of cirrhosis. After TIPS, CXCL11levels correlated with the degree of portal pressure and patients with higher CXCL11-levels in portal and hepatic veinsshowed higher mortality. Multivariate analysis revealed hepatic CXCL11-levels before TIPS, creatinine and age as independent predictors for survival in TIPS patients, whereas MELD score and low portal CXCL11-levels after TIPS predicted long-term survival. Conclusion CXCL11levels are mainly increased in patients with non- alcoholic cirrhosisand high portal pressure. Moreover, levels of CXCL11might predict long-time survival of cirrhotic patients bearing TIPS.