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Updated: Jul 30, 2026
Selective Harvesting of Marginating-pulmonary Leukocytes
Published on: March 11, 2016
Timing of leukocyte filtration during cardiopulmonary bypass
1Department of Thoracic and Cardiovascular Surgery, JW Goethe University, Frankfurt, Germany. matheis.gbr@gmx.de
Insights
Leukocyte filtration during cardiac surgery may reduce myocardial damage. This study evaluates optimized protocols and filtration strategies to mitigate leukocyte-induced harm during cardiopulmonary bypass and reperfusion.
Area of Science:
- Cardiovascular Surgery
- Immunology
- Biomedical Engineering
Background:
- Leukocyte filtration is used during cardiopulmonary bypass (CPB) in cardiac surgery.
- Current protocols for leukocyte filtration timing and duration require further optimization.
- Leukocyte pathogenicity during CPB and reperfusion is a significant concern.
Purpose of the Study:
- To evaluate short-term leukocyte filtration during reperfusion to reduce myocardial damage in coronary artery bypass graft (CABG) patients.
- To compare the efficacy of different filtration strategies in reducing CPB- and reperfusion-associated leukocyte pathogenicity.
- To discuss current efforts in improving leukocyte filtration protocols.
Main Methods:
- A double-blind randomized study in routine CABG patients.
- Evaluation of leukocyte filtration during aortic crossclamp release (reperfusion phase).
- Comparison of three distinct filtration concepts using clinical endpoints, laboratory variables, and in vitro assays.
Main Results:
- Data presented on the efficacy of different filtration approaches.
- Analysis of clinical outcomes, laboratory markers, and functional assays related to leukocyte activity.
- Findings aim to inform optimized leukocyte filtration protocols.
Conclusions:
- Optimized leukocyte filtration protocols are crucial for improving outcomes in cardiac surgery.
- Targeted filtration strategies can mitigate leukocyte-induced damage during CPB and reperfusion.
- Further research is needed to refine filtration timing and duration for maximum benefit.
Abstract:
The effects of leukocyte filtration on the outcome of cardiac surgery with cardiopulmonary bypass (CPB) have been shown by numerous investigators. In the majority of cases a leukocyte filter is placed in the arterial line instead of a standard arterial line filter and used throughout CPB. However, protocols to optimize onset and duration of leukocyte filtration have not been sufficiently evaluated to date. In this paper, current efforts to improve such protocols are demonstrated and discussed. These efforts are based on studies of leukocyte pathogenicity during cardiac surgery. A first study (double-blind randomized) was performed in routine coronary artery bypass graft (CABG) patients to evaluate whether short-term leukocyte filtration during reperfusion by release of the aortic crossclamp would reduce reperfusion-associated myocardial damage. Further data compare the efficacy of three different filtration concepts to reduce CPB- and/or reperfusion-associated leukocyte pathogenicity. Clinical endpoints, standard laboratory variables and functional in vitro assays are provided and discussed.
