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: 84 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 0.3mug*kg(-1) *min(-1) , P=0.039 and 0.06 vs 0.32mug*kg(-1) *min(-1) , P=0.047). The inflammatory responses were similar in the two groups. There was a trend towards 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. However, the frequency of renal replacement therapy was significantly less in the CA-treated than in controls (P=0.031). CONCLUSIONS: Intraoperative CA treatment was associated with reduced vasopressor demand and less frequent renal replacement therapy with a favorable tendency in length of mechanical ventilation and ICU stay. CA treatment was not linked to higher rates of adverse events. This article is protected by copyright. All rights reserved.