Abstract: FR-PO979

Renal Protection during Cardiopulmonary Bypass (CPB) with a Leukocyte Modulatory Device (L-MOD)

Session Information

Category: Bioengineering and Informatics

  • 101 Bioengineering and Informatics

Authors

  • Humes, H. David, University of Michigan Medical School, Ann Arbor, Michigan, United States
  • Westover, A., Innovative BioTherapies, Inc., Ann Arbor, Michigan, United States
  • Buffington, D., Innovative BioTherapies, Inc., Ann Arbor, Michigan, United States
  • Johnston, K., Innovative BioTherapies, Ann Arbor, Michigan, United States
Background

Leukocyte activation during cardiopulmonary bypass (CPB) contributes to a systemic inflammatory response that can cause organ injury and dysfunction, including the kidney. The therapeutic value of incorporating an extracorporeal leukocyte modulatory device (L-MOD) during and after CPB was investigated. Assessment of leukocyte mediated organ injury in a pre-clinical animal model was the primary outcome criteria.

Methods

Twenty-two pigs underwent a simulated cardiothoracic surgical procedure with 180 minutes of CPB and 5 hours post-operative observation. Pigs received CPB with no intervention (Group 1, n= 9), 3 hours of L-MOD therapy by incorporation of L-MOD into the CPB circuit (Group 2, n=6) or 8 hours of L-MOD therapy using a femoral veno-venous extracorporeal circuit during and after CPB (Group 3, n=7). Leukocyte counts and activation were serially measured. Hemodynamics, pulmonary parameters and urine output were monitored as indices of organ function. Serum troponin-I and urine neutrophil gelatinase-associated lipocalin (NGAL) served as biomarkers of organ injury for heart and kidney, respectively.

Results

Leukocyte activation at the end of CPB was significantly increased in Groups 1 and 2 but not Group 3. Leukocyte counts, namely neutrophils, significantly increased post-operatively in Groups 1 and 2 but not in Group 3. Systemic vascular resistance was not as reduced post CPB for the L-MOD treated pigs and at 5 hours post CPB, organ injury markers, troponin-I and NGAL, were lowest in Group 3.

Conclusion

8 hours of L-MOD therapy limited leukocyte activation and the inflammatory response to CPB which resulted in less organ injury and dysfunction, including the kidney. Continuation of L-MOD therapy into the post-operative period was required for therapeutic impact.

Funding

  • Other NIH Support