Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated...

The aim of this study was to investigate the modulatory effect of intraoperative hemoadsorption (HA) versus standard care on the perioperative inflammatory profile of patients undergoing orthotopic heart transplantation (OHT) and its correlation with the severity of post-transplant vasoregulatory dysfunction.

In this secondary analysis, data from NCT03145441, a prospective, single-center, open-label, randomized controlled trial were used.

Patients in the HA group had a lower median vasopressor score, rate of severe vasoregulatory dysfunction (vasopressor score: 19.7 [7.9-37.8] vs. 35.6 [14.5-57.6], p = 0.031, respectively and severe vasoregulatory dysfunction: 33.3% vs. 60.0% p = 0.048, respectively), and reduced procalcitonin (PCT) level (PCT: 0.93 [0.38-2.36] μg/L vs. 2.08 [1.13-6.36] μg/L, p = 0.007, respectively) during the early postoperative period than patients in the control group. The 24-h cytokine and complement levels were comparable in the study groups. The 24-h inflammatory profile of HA and control groups remained unchanged in the cluster of severe vasoregulatory dysfunction. There was a moderate positive correlation between the vasopressor score and the PCT concentration in the control group (r _S: 0.605, p = 0.002) which was not identified in the HA group.

Intraoperative HA treatment exerts a beneficial modulatory effect on the postoperative PCT response in OHT recipients, which is directly associated with significantly lower rates of post-transplant severe vasoregulatory dysfunction compared to controls.