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J Thorac Cardiovasc Surg 2005;130:952-953
© 2005 The American Association for Thoracic Surgery

Letters to the Editor

Uses of the leukocyte-depleting filter

Department of Cardiothoracic Surgery, Guy's Hospital, London SE1 9RT, United Kingdom

To the Editor:

I was interested to read Ilmakunnas and colleagues' recent article, ¹ in which they showed that the Pall LG6 leukocyte-depleting filter (Pall Biomedical, Portsmouth, United Kingdom) quite clearly does not reduce the activation of neutrophils and monocytes in clinical practice. As they explained, the previous literature on this subject has been quite unclear, with some finding a reduction in inflammatory markers and others finding a marked increase in elastase. ^2,3 My colleagues and I ⁴ recently found that the LG6 filter significantly reduces cerebral microemboli detected by transcranial Doppler but also raises serum elastase. The mechanism by which the LG6 filter reduces microemboli is unknown but unlikely to be inflammatory mediated, according to Ilmakunnas and colleagues' results, ¹ and is therefore more likely to be a simple physical effect. Although the reduction in microemboli was not accompanied by a significant improvement in neuropsychologic outcome, ⁴ the LG6 filter still has the potential for benefit by reducing microemboli.

References

1. Ilmakunnas M, Pesonen EJ, Ahonen J, Ramo J, Siitonen S, Repo H. Activation of neutrophils and monocytes by a leukocyte-depleting filter used throughout cardiopulmonary bypass. J Thorac Cardiovasc Surg 2005;129:851-859.[Abstract/Free Full Text]
   
2. Mair P, Hoermann C, Mair J, Margreiter J, Puschendorf B, Balogh D. Effects of a leucocyte depleting arterial line filter on perioperative proteolytic enzyme and oxygen free radical release in patients undergoing aortocoronary bypass surgery. Acta Anaesthesiol Scand 1999;43:452-457.[Medline]
   
3. Mihaljevic T, Tonz M, von Segesser LK, Pasic M, Grob P, Fehr J, et al. The influence of leukocyte filtration during cardiopulmonary bypass on postoperative lung function. A clinical study. J Thorac Cardiovasc Surg 1995;109:1138-1145.
   
4. Whitaker DC, Newman SP, Stygall J, Hope-Wynne C, Harrison MJ, Walesby RK. The effect of leucocyte-depleting arterial line filters on cerebral microemboli and neuropsychological outcome following coronary artery bypass surgery. Eur J Cardiothorac Surg 2004;25:267-274.[Abstract/Free Full Text]
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Donald Whitaker Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Whitaker, D. Search for Related Content PubMed PubMed Citation Articles by Whitaker, D. Related Collections Cardiac - physiology Cerebral protection Extracorporeal circulation