Leukocyte depletion attenuates expression of neutrophil adhesion molecules during cardiopulmonary bypass in human beings

Chen, Ying-Fu; Tsai, Wen‐Chan; Lin, Ching-Cheng; Lee, Chee-Siong; Huang, Chiung‐Hui; Pan, Pi-Chen; Chen, Manlin; Huang, Yeo-Shin

doi:10.1067/mtc.2002.119065

Cited by 31 publications

(31 citation statements)

References 33 publications

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“…The mechanism of increased PGF 2α after leukoreduction in our study is unclear, but PGFS may have been released from lymphocytes activated during the filtration process. Some studies have described leukocyte activation with the use of leukocyte depletion filters,37, 38, 39 but these findings were not consistently replicated in other leukoreduction studies 40, 41, 42, 43. Furthermore, leukocyte rupture is possible with prolonged filtration, resulting in free enzymes and other cellular components 44.…”

Section: Discussionmentioning

confidence: 99%

Effects of Leukoreduction and Storage on Erythrocyte Phosphatidylserine Expression and Eicosanoid Concentrations in Units of Canine Packed Red Blood Cells

Muro

Lee

Ross

et al. 2017

Veterinary Internal Medicne

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BackgroundStorage of canine packed red blood cells (pRBCs) can increase erythrocyte phosphatidylserine (PS) expression and eicosanoid concentrations.Hypothesis/ObjectivesTo determine the effects of leukoreduction on erythrocyte PS expression and eicosanoid concentrations in stored units of canine pRBCs. Our hypothesis was that leukoreduction would decrease PS expression and eicosanoid concentrations.AnimalsEight healthy dogs.MethodsIn a cross‐over study, units of whole blood were leukoreduced (LR) or non‐LR and stored (10 and 21 days) as pRBCs. Samples were collected at donation, and before and after a simulated transfusion. PS expression was measured by flow cytometry, and concentrations of arachidonic acid (AA), prostaglandin F2α (PGF 2α), prostaglandin E2 (PGE 2), prostaglandin D2 (PGD 2), thromboxane B2 (TXB 2), 6‐keto‐prostaglandin F1α (6‐keto‐PGF 1α), and leukotriene B4 (LTB 4) were quantified by liquid chromatography–mass spectrometry.ResultsThere was no change in PS expression during leukoreduction, storage, and simulated transfusion for non‐LR and LR units. Immediately after leukoreduction, there was a significant increase in TXB 2 and PGF 2α concentrations, but during storage, these eicosanoids decreased to non‐LR concentrations. In both LR and non‐LR units, 6‐keto‐PGF 1α concentrations increased during storage and simulated transfusion, but there was no difference between unit type. There was no difference in AA, LTB 4, PGE 2, and PGD 2 concentrations between unit types.Conclusions and Clinical ImportanceLeukoreduction, storage, and simulated transfusion do not alter erythrocyte PS expression. Leukoreduction causes an immediate increase in concentrations of TXB 2 and PGF 2α, but concentrations decrease to non‐LR concentrations with storage. Leukoreduction does not decrease the accumulation of 6‐keto‐PGF 1α during storage.

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Section: Discussionmentioning

confidence: 99%

Effects of Leukoreduction and Storage on Erythrocyte Phosphatidylserine Expression and Eicosanoid Concentrations in Units of Canine Packed Red Blood Cells

Muro

Lee

Ross

et al. 2017

Veterinary Internal Medicne

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“…In a study that included only three patients (one filtered and two controls), Thurlow et al observed a gradient in the expression of CD11a and CD45RO across the filter not seen in the two control patients and also claimed that the filter selectively removed activated leukocytes [40]. The effect of filtration on CD-11b expression appears to be variable, with no difference [27,39], downregulation [51] and up-regulation of CD-11b [48] all having been reported. In a clinical study on patients undergoing CABG surgery by Chen et al [52], L-selectin, P-selectin, ICAM-1 and PECAM-1 were all significantly reduced by leukofiltration.…”

Section: Does Systemic Leukofiltration Reduce Markers Of Systemic Infmentioning

confidence: 99%

“…Of the 26 that did, 15 found no significant difference between filtered patients and controls at any point in the patients admission [9,22,23,27,[39][40][41][42][43][44][45][46][47][48][49][50]. The remaining 11 papers found reduced WCCs in the filtered group mainly during CPB, although these differences tended to disappear after CPB [10,26,35,[51][52][53]. Hachida et al showed a significantly lower WCC in the filtered group only at 15 min post-bypass measurement [54].…”

Section: Does Systemic Leukofiltration Reduce Leukocyte Counts?mentioning

confidence: 99%

The effects of various leukocyte filtration strategies in cardiac surgery

Warren

Alexiou

Massey

et al. 2007

European Journal of Cardio-Thoracic Surgery

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It is known that cardiopulmonary bypass causes an inflammatory reaction with an associated morbidity and mortality. Several anti-inflammatory strategies have been implemented to reduce this response, including leukocyte removal from the circulation using specialised filters. The aim of this study is to systematically review the available evidence on leukocyte filtration in cardiac surgery, focusing on its effect on systemic inflammation and whether this has influenced clinical outcomes. Five electronic databases were systematically searched for studies reporting the effect of leukocyte filtration at any point within the cardiopulmonary bypass circuit in humans. Reference lists of all identified studies were checked for any missing publications. Two authors independently extracted the data from the included studies. Whilst systemic leukodepleting filters do not appear to consistently lower leukocyte counts, they may preferentially remove activated leukocytes. Small improvements in early post-operative lung function in patients receiving systemic leukodepletion have been reported, but this does not lead to reduced hospital stay or decreased mortality. There is substantial evidence that cardioplegic leukocyte filtration attenuates the reperfusion injury at a cellular level, but this has not been translated into clinical improvements. Finally, whilst various strategies involving multiple leukocyte filters, or the incorporation of pharmacological agents into leukocyte-depleting protocols have been evaluated, the current available results are not conclusive. Our study suggests that there is not enough high quality or consistent evidence to draw guidelines regarding the use of leukocyte-depleting filters within routine cardiac surgical practice.

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“…For instance, the expression of selectins is increased after the start of CPB [1,53], and this process initiates neutrophil rolling, adherence to the endothelium, and transmigration across the vascular wall [54]. Granulocyte apoptosis is also decreased after CPB, effectively prolonging the functional lifespan of neutrophils [55].…”

Section: Leukocyte Activationmentioning

confidence: 99%

Vasomotor dysfunction after cardiac surgery

Ruel

Khan

Voisine

et al. 2004

European Journal of Cardio-Thoracic Surgery

106

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Cardiopulmonary bypass and cardioplegic arrest, which allow for support of the circulation and stabilization of the heart during cardiac procedures, are still used for the vast majority of cardiac operations worldwide. However, in addition to a well-recognized systemic inflammatory response, cardiopulmonary bypass and cardioplegic arrest elicit complex, multifactorial vasomotor disturbances that vary according to the affected organ bed, with reduced vascular resistances in the skeletal muscle and peripheral circulation, and increased propensity to spasm in the cardiac, pulmonary, mesenteric and cerebral vascular beds. This article outlines the nature, mechanistic basis, and clinical correlates of the vasomotor alterations encountered in patients undergoing cardiac surgery using cardiopulmonary bypass and cardioplegic arrest.

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Leukocyte depletion attenuates expression of neutrophil adhesion molecules during cardiopulmonary bypass in human beings

Cited by 31 publications

References 33 publications

Effects of Leukoreduction and Storage on Erythrocyte Phosphatidylserine Expression and Eicosanoid Concentrations in Units of Canine Packed Red Blood Cells

Effects of Leukoreduction and Storage on Erythrocyte Phosphatidylserine Expression and Eicosanoid Concentrations in Units of Canine Packed Red Blood Cells

The effects of various leukocyte filtration strategies in cardiac surgery

Vasomotor dysfunction after cardiac surgery

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