Nikola Sliskovic, Gloria Sestan, Savica Gjorgjievska, Davor Baric, Daniel Unic, Josip Varvodic, Marko Kusurin, Dubravka Susnjar, Sarah Singer, Igor Rudez
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Primary outcome measures included postoperative hemodynamic stability and blood product requirements, while secondary outcomes were the incidence of acute kidney injury requiring dialysis (AKI-d) and 30-day mortality.</p><p><strong>Results: </strong>Postoperatively, the vasoactive-inotropic score (VIS) did not significantly differ between the groups. However, the use duration for milrinone and dobutamine was shortened by one day compared to controls. The HA group had fewer red blood cell transfusions (765 vs. 1330 mL, <i>p</i> = 0.01) and lower fresh frozen plasma requirements (945 vs. 1200 mL, <i>p</i> = 0.04). Mechanical ventilation duration was reduced (22 vs. 28 h, <i>p</i> = 0.02). AKI-d rates were similar, and 30-day mortality favored non-significantly the HA group (5% vs. 14.6%, <i>p</i> = ns). No device-related adverse events were observed.</p><p><strong>Conclusion: </strong>These findings suggest that intraoperative HA might improve immediate postoperative outcomes; however, further validation in larger randomized controlled trials is warranted.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12028209/pdf/","citationCount":"0","resultStr":"{\"title\":\"Intraoperative Hemoadsorption in Heart Transplant Surgery: A 5-Year Experience.\",\"authors\":\"Nikola Sliskovic, Gloria Sestan, Savica Gjorgjievska, Davor Baric, Daniel Unic, Josip Varvodic, Marko Kusurin, Dubravka Susnjar, Sarah Singer, Igor Rudez\",\"doi\":\"10.3390/jcdd12040119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hyperimmune response and cytokine release post-reperfusion might occur after orthotopic heart transplantation (HTx). 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The HA group had fewer red blood cell transfusions (765 vs. 1330 mL, <i>p</i> = 0.01) and lower fresh frozen plasma requirements (945 vs. 1200 mL, <i>p</i> = 0.04). Mechanical ventilation duration was reduced (22 vs. 28 h, <i>p</i> = 0.02). AKI-d rates were similar, and 30-day mortality favored non-significantly the HA group (5% vs. 14.6%, <i>p</i> = ns). 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引用次数: 0
摘要
背景:原位心脏移植(HTx)术后可能出现超免疫反应和再灌注后细胞因子释放。术中血液吸附(HA)已被引入以去除这种升高的细胞因子。我们的目的是分析术中HA对原位HTx患者的影响。方法:在2018年至2022年期间,将40例连续接受术中血液吸附HA合并体外循环的原位HTx患者与41例历史对照进行比较。主要结局指标包括术后血流动力学稳定性和血液制品需求,次要结局指标是需要透析的急性肾损伤发生率(AKI-d)和30天死亡率。结果:两组术后血管活性-肌力评分(VIS)差异无统计学意义。然而,与对照组相比,米立酮和多巴酚丁胺的使用时间缩短了一天。HA组红细胞输注量较少(765比1330 mL, p = 0.01),新鲜冷冻血浆需用量较低(945比1200 mL, p = 0.04)。机械通气时间缩短(22 h vs. 28 h, p = 0.02)。AKI-d率相似,HA组30天死亡率无明显优势(5% vs. 14.6%, p = ns)。未观察到与器械相关的不良事件。结论:术中HA可改善术后即刻预后;然而,在更大的随机对照试验中进一步验证是有必要的。
Intraoperative Hemoadsorption in Heart Transplant Surgery: A 5-Year Experience.
Background: Hyperimmune response and cytokine release post-reperfusion might occur after orthotopic heart transplantation (HTx). Intraoperative hemoadsorption (HA) has been introduced to remove such elevated cytokines. We aimed to analyze the effect of intraoperative HA in patients undergoing orthotopic HTx.
Methods: Between 2018 and 2022, 40 consecutive orthotopic HTx patients who underwent intraoperative hemoadsorption HA integrated into the cardiopulmonary bypass were compared to 41 historical controls. Primary outcome measures included postoperative hemodynamic stability and blood product requirements, while secondary outcomes were the incidence of acute kidney injury requiring dialysis (AKI-d) and 30-day mortality.
Results: Postoperatively, the vasoactive-inotropic score (VIS) did not significantly differ between the groups. However, the use duration for milrinone and dobutamine was shortened by one day compared to controls. The HA group had fewer red blood cell transfusions (765 vs. 1330 mL, p = 0.01) and lower fresh frozen plasma requirements (945 vs. 1200 mL, p = 0.04). Mechanical ventilation duration was reduced (22 vs. 28 h, p = 0.02). AKI-d rates were similar, and 30-day mortality favored non-significantly the HA group (5% vs. 14.6%, p = ns). No device-related adverse events were observed.
Conclusion: These findings suggest that intraoperative HA might improve immediate postoperative outcomes; however, further validation in larger randomized controlled trials is warranted.