Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices.

Artificial organs 2022 Jan

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The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival. Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients). WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up. Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation. © 2021 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.

Citation

Konstantin Zhigalov, Jef Van den Eynde, Alina Zubarevich, Thomas Chrosch, Lukas Goerdt, Arian Arjomandi Rad, Robert Vardanyan, Michel Pompeu Barros Oliveira Sá, Peter Luedike, Nikolaus Pizanis, Achim Koch, Bastian Schmack, Markus Kamler, Arjang Ruhparwar, Alexander Weymann. Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices. Artificial organs. 2022 Jan;46(1):95-105