Clinical performance of a high-efficiency rapid flow leucocyte removal filter for leucocyte depletion of heparinized cardiopulmonary bypass perfusate

Gu, Yongquan; deVries, AJ; Boonstra, PW; Oeveren, Willem van

doi:10.1177/026765919501000606

Cited by 15 publications

(10 citation statements)

References 16 publications

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“…This facilitates the adherence of the leukocytes on the fibers of the filter (16). The overall reduction in platelet counts in the LipiGuard group and in the Biofil group is in agreement with our previous findings in residual heart–lung machine blood where we found a 50% reduction in platelet counts after the filter (14). However, platelets were almost completely removed by the RS1 filter.…”

Section: Discussionsupporting

confidence: 92%

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Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

Vries¹,

Vermeijden²,

et al. 2006

Artificial Organs

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Activated leukocytes and fat particles are associated with organ injury after a cardiac surgery. Filters are currently used to remove either leukocytes or fat particles. A novel approach with a filter that combines leukocyte and fat removal might be clinically useful. As it is not known which type of filter has a good and safe performance in both leukocyte and fat removal, we measured in this study the leukocyte and fat removal properties and the biocompatibility of three different filters. We used six Pall RS1 (Pall, Portsmouth, England) leukocyte removal filters, six Pall LipiGuard fat removal filters, and six Fresenius Biofil 02 (Fresenius, Emmer-Compascuum, The Netherlands) leukocyte removal filters and measured the passage times of 500 and 1000 mL of residual heart-lung machine blood. We determined the circulating leukocyte and platelet counts, and total hemoglobin, triglyceride, and free fatty acid concentration after the filters. In addition, we measured free hemoglobin, plasma elastase (Merck, Darmstadt, Germany), and complement C5-9 (Quidel, San Diego, CA, U.S.A.) to assess the biocompatibility of the filters. The circulating fat particles were calculated with an automated hematology analyzer. The passage time for the blood was shortest for the Biofil filter (P = 0.02, analysis of variance). The total leukocyte counts (P = 0.04) and fat particles (P = 0.02) were higher after the LipiGuard filter. This filter also had a higher increase in free hemoglobin concentration (P = 0.03). We conclude that the leukocyte removal filters were superior to the fat removal filter both in leukocyte and fat removal.

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Section: Discussionsupporting

confidence: 92%

“…The filter efficiency of the Pall RS1 and the Fresenius Biofil 02 leukocyte removal filters in this setting was about 98%. This is lower than is expected from the data for blood bank use, but is in agreement with a previous study where for residual heart–lung machine blood, a removal rate of 95–97% was found (14).…”

Section: Discussionsupporting

confidence: 91%

Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

Vries¹,

Vermeijden²,

et al. 2006

Artificial Organs

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“…Until now, most studies have focused on concentrating the CPB perfusate prior to retransfusion, 32 or on leukocyte depletion of the CPB perfusate without cell washing. 33,34 However, little is known about the leukocyte removal efficiency of cell-washed and unwashed whole blood. In the DiffLR was calculated as described in the Methods section.…”

Section: Discussionmentioning

confidence: 99%

Leukocyte removal efficiency of cell-washed and unwashed whole blood: an in vitro study

et al. 2005

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Leukocyte filtration of the cardiopulmonary bypass (CPB) perfusate after cardiac surgery has evolved as an important technique to prevent effector functions mediated by activated leukocytes. However, little is known about the filtration efficiency. Therefore, an in vitro study was conducted to define the leukocyte removal rate of a transfusion leukocyte-depletion filter, using cell-washed and unwashed whole porcine blood. In addition, the influence of different cell-washing protocols on the elimination rate of blood cells (leukocytes and platelets) was investigated. Fresh, diluted, pooled, heparinized, porcine blood was processed using either a high-flow (HF, n = 5) or quality-wash (QW, n = 5) protocol on a continuous auto-transfusion system, or was left unprocessed (control n=5). Thereafter, all samples were filtered using a transfusion leukocyte-depletion filter. Blood samples for measurement of hematocrit, white blood cell count, including leukocyte differentiation and platelet count, were taken before and after filtration. To compare the experimental groups, the removal rate was presented as the fraction of leukocytes or platelets removed per plasma volume. Cell washing significantly altered the fraction of leukocytes removed per plasma volume when compared to unprocessed blood (2.07 and 2.36 in the HF and QW groups, respectively, versus 1.34 in the control group, p = 0.008 for both). No statistically significant difference in leukocyte removal rate was observed between the different cell-washing protocols. The leukocyte differential count showed that, during all experiments, the neutrophils were removed most efficiently (99.7%). Overall, significantly more platelets were depleted after cell washing compared to the control group (1.47 and 1.60 in the HF and QW groups, respectively, versus 1.12 in the control group, p =0.008 and 0.032, respectively). Furthermore, the amount of blood that could be filtered using a single pass technique did not significantly differ between the experimental groups. However, a larger variation in the total amount of filtered blood was observed in the unprocessed group (570+/-398 mL) compared to the cell-washed groups (360+/-42 and 430+/-97 mL in the HF and QW groups, respectively). In conclusion, blood processing with an auto-transfusion system significantly enhances the leukocyte and platelet removal efficiency of the transfusion leukocyte-depletion filter that was studied. In particular, neutrophils were efficiently removed.

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“…Several authors have been able to show, that reperfusion injury to cardiac and pulmonary tissue is diminished by leukocyte filtration in the arterial line [5,6] or the venous line [7], and that leukocyte filtration in the blood cardioplegia delivery system can improve myocardial protection [8]. Despite these promising results, postoperative complications including systemic immune response syndrome (SIRS), myocardial and pulmonary reperfusion injury, and cerebral damage remain critical issues [1,2,9].…”

Section: Introductionmentioning

confidence: 99%

Leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery

et al. 2002

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Clinical performance of a high-efficiency rapid flow leucocyte removal filter for leucocyte depletion of heparinized cardiopulmonary bypass perfusate

Cited by 15 publications

References 16 publications

Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

Clinical Efficacy and Biocompatibility of Three Different Leukocyte and Fat Removal Filters During Cardiac Surgery

Leukocyte removal efficiency of cell-washed and unwashed whole blood: an in vitro study

Leukocyte filtration fails to limit functional neutrophil activity during cardiac surgery

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