[Thrombomodulin as endothelial cell marker in heart surgery patients]

Thrombomodulin is a high-affinity receptor for thrombin on the endothelial cell surface. The aim of our study was to investigate whether plasma thrombomodulin represents a marker of endothelial injury following cardiopulmonary bypass.

Plasma levels of thrombomodulin were quantitated in 70 plasma samples obtained from 14 adult cardiac patients undergoing hypothermic pulsatile low-flow low-pressure cardiopulmonary bypass. Blood samples were taken before cardiopulmonary bypass (T1), and 15 minutes (T2), 1 hour, 6 hours, and 20 hours after termination of bypass. Plasma thrombomodulin was quantitated with a sandwich enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by the Friedman and Wilcoxon tests.

Plasma thrombomodulin was significantly elevated 20 hours after discontinuation of cardiopulmonary bypass, when compared with T1 and T2.

We conclude from our results that a moderate elevation of plasma thrombomodulin is seen in adult patients following hypothermic, low-flow low-pressure cardiopulmonary bypass, which may reflect endothelial injury. Circulating thrombomodulin levels are thus possibly useful for assessment of endothelial damage occurring in patients undergoing cardiopulmonary bypass.