Impact of intraoperative cytokine adsorption on outcome of patients undergoing orthotopic heart transplantation-an observational study.

Abstract

AIM:

The aim of this study was to assess the influence of intraoperative cytokine adsorption on the perioperative vasoplegia, inflammatory response and outcome during orthotopic heart transplantation (OHT).

METHODS:

Eighty-four OHT patients were separated into the cytokine adsorption (CA)-treated group or controls. Vasopressor demand, inflammatory response described by procalcitonin and C-reactive protein, and postoperative outcome were assessed performing propensity score matching.

RESULTS:

In the 16 matched pairs, the median noradrenaline requirement was significantly less in the CA-treated patients than in the controls on the first and second postoperative days (0.14 vs 0.3 μg*kg-1 *min-1 , P = .039 and 0.06 vs 0.32 μg*kg-1 *min-1 , P = .047). The inflammatory responses were similar in the two groups. There was a trend toward shorter length of mechanical ventilation and intensive care unit (ICU) stay in the CA-treated group compared to the controls. No difference in adverse events was observed between the two groups. The frequency of renal replacement therapy was less in the CA‐treated patients than in the controls.

CONCLUSIONS:

Intraoperative CA treatment was associated with reduced vasopressor demand with a favorable tendency in length of mechanical ventilation, ICU stay and renal replacement therapy. CA treatment was not linked to higher rates of adverse events.

• Authors: Endre Nemeth, Eniko Kovacs, Kristof Racz, Adam Soltesz, Szabolcs Szigeti, Nikolett Kiss, Gergely Csikos, Kinga B Koritsanszky, Viktor Berzsenyi, Gabor Trembickij, Szabolcs Fabry, Zoltan Prohaszka, Bela Merkely, Janos Gal
• Journal: Clinical transplantation (Clin Transplant) Vol. 32 Issue 4 Pg. e13211 (04 2018) ISSN: 1399-0012 [Electronic] Denmark
• PMID: 29377282 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Cytokines

Topics

• Adult
• Case-Control Studies
• Cytokines (administration & dosage, metabolism)
• Female
• Follow-Up Studies
• Heart Transplantation (adverse effects, methods)
• Humans
• Inflammation (etiology, prevention & control)
• Intensive Care Units
• Intraoperative Care
• Length of Stay
• Male
• Middle Aged
• Postoperative Complications (etiology, prevention & control)
• Prognosis
• Propensity Score
• Prospective Studies
• Renal Replacement Therapy (statistics & numerical data)
• Vasoplegia (etiology, prevention & control)