Effects of Leukocyte-depleted Reoxygenation on Endothelial and Ventricular Function: With Observation of a Short Time Period
Yoshimasa Sakamoto, MD, Liu Hua Wei, MD, Gerald D. Buckberg, MD, and Helen H. Youg, PhD
Postoperative myocardial global dysfunction causes mortality and morbidity in cyanotic congenital defects. This study investigates whether leukocyte depletion during coronary perfusion following reoxygenation can maintain endothelial and myocyte function, or less oxidant damage in a porcine neonatal model. After 30 minutes hypoxemia, 13 piglets underwent 60 minutes reoxygenation. The aorta was clamped and coronary reperfusion was either with normal blood (N=6), or leukocyte free blood by an inline filter (N=7). Cardiac function and endothelial response were assessed before and after cardiopulmonary bypass (CPB). Contractile recovery was improved by leukocyte depletion. Additionally, the antioxidant reserve capacity reserved more (534±36 versus 772±91; p<0.05) than reoxygenation without a leukocyte-depleting filter. Leukocyte depletion returned more extreme relaxation to acetylcholine (71.8±20.4% versus 41.2±9.8%; p<0.05), but did not change the endothelium-independent relaxation to sodium nitroprusside in either group. Activated leukocytes release oxygen free radicals that play a role in deterioration of the endothelial/myocardial function after reoxygenation and this deterioration in cyanotic heart diseases may be avoided by the use of the leukocyte-depleting filter. (Ann Thorac Cardiovasc Surg 2002; 8: 343-343)
Key words: reoxygenation, leukocyte depletion, endothelial cell dysfunction
From Division of Cardiothoracic Surgery, UCLA School of Medicine, Los Angeles, CA, USA
Received January 7, 2002; accepted for publication August 22, 2002
Address reprint requests to Yoshimasa Sakamoto, MD: Department of Cardiovascular Surgery, Machida City Hospital, 2-15-41, Asahimachi, Machida-shi, Tokyo 194-0023, Japan.