J Thorac Cardiovasc Surg 2005;130:952-953
© 2005 The American Association for Thoracic Surgery
Uses of the leukocyte-depleting filter
Donald Whitaker, FRCS(ED)
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,
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.
My colleagues and I
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,
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,
the LG6 filter still has the potential for benefit by reducing microemboli.
- 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]
- 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]
- 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.[Abstract/Free Full Text]
- 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]