Clinical evaluation of a leucocyte-depleting blood cardioplegia filter (BC1B) for elective open-heart surgery

Abstract

Activation of leucocytes during extracorporeal circulation has attracted attention in recent years as a cause of reperfusion injury in open-heart surgery patients. In the present study, 40 adult patients undergoing elective open-heart surgery were randomized into two groups: 20 using the Pall BC1B leucocyte-depleting filter for blood cardioplegia (group 1) and the other 20 without the filter (group 2). In order to determine if the filter was effective in protecting the myocardium, CPK-MB and troponin-T (TnT) were measured. In addition, efforts were also made to determine appropriate sites at which the BC1B blood cardioplegia filter should be positioned. There were no significant differences between the two groups in terms of conditions of perfusion. No adverse effects were seen in either group. The total leucocyte reduction rate through the filter was 98.1% with the passage of 2 litres of blood through the filter. A pressure drop of 4.4 ± 3.2 mmHg was observed through the filter during use. Statistically significant differences were noted between the two groups in CPK-MB ( p = 0.031) and TnT ( p = 0.004). Findings obtained in previous studies demonstrate that the various advantages of leucocyte reduction, shown in experimental studies, can be translated into clinical advantages. In conclusion, based on the results in this clinical study showing significant difference in CPK-MB and TnT which are known effective indicators for myocardial injury, between leucoreduced and non-leucoreduced group, the Pall BC1B leucocyte-depleting filter for blood cardioplegia has been shown to be effective in alleviating reperfusion injury in open-heart surgery patients.