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J Thorac Cardiovasc Surg 2005;129:851-859
© 2005 The American Association for Thoracic Surgery

Evolving Technology

Activation of neutrophils and monocytes by a leukocyte-depleting filter used throughout cardiopulmonary bypass

^a Department of Bacteriology and Immunology, University of Helsinki, Finland
^b the Department of Anesthesia and Intensive Care Medicine, University of Helsinki, Finland
^c the Department of Thoracic and Cardiovascular Surgery, University of Helsinki, Finland
^d the Department of Clinical Chemistry, University of Helsinki, Finland
^e the Division of Infectious Diseases, University of Helsinki, Finland

Received for publication February 13, 2004; revisions received June 29, 2004; accepted for publication July 14, 2004.

^_* Address for reprints: Eero Pesonen, MD, PhD, Department of Anesthesia and Intensive Care Medicine, University Hospital of Helsinki, PL 340, 000290 HUS, Helsinki, Finland (E-mail: eero.pesonen{at}kolumbus.fi).

OBJECTIVE: Cardiopulmonary bypass elicits systemic inflammation. Depletion of circulating leukocytes might alleviate inflammatory response. We studied the effects of a leukocyte-depleting filter on phagocyte activation during cardiopulmonary bypass.

METHODS: Fifty patients undergoing coronary artery bypass grafting were randomly allocated into an arterial line leukocyte filter group (n = 25) with a Pall LeukoGuard 6 leukocyte-depleting filter (LG6; Pall Biomedical, Portsmouth, United Kingdom) and a control group without any filter (n = 25). Blood sampling took place from arterial line at predetermined time points. In the filter group, the sample was taken immediately before the filter; to evaluate activation at the site, an additional sample was taken immediately after the filter. CD11b/CD18 and L-selectin expressions and basal production of hydrogen peroxide were determined with whole-blood flow cytometry, and plasma lactoferrin level was determined with enzyme-linked immunosorbent assay.

RESULTS: Neutrophil CD11b expression was higher in the filter group than in the control group (P < .001). Likewise, monocyte CD11b expression, neutrophil hydrogen peroxide production, and lactoferrin plasma levels were all significantly higher, whereas neutrophil and monocyte counts and neutrophil L-selectin expression were all significantly lower in the filter group (all P < .001). At 5 minutes of CPB, CD11b expression increased across the filter on neutrophils (median difference 197 relative fluorescence units, range 45–431 relative fluorescence units, P < .001) and monocytes (median difference 26 relative fluorescence units, range –68–111 relative fluorescence units, P < .001).

CONCLUSION: The LG6 arterial line leukocyte filter is ineffective in its principal task of diminishing phagocyte activation during cardiopulmonary bypass.

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