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  • Title: Leukocyte depletion of blood cardioplegia attenuates reperfusion injury.
    Author: Schmidt FE, MacDonald MJ, Murphy CO, Brown WM, Gott JP, Guyton RA.
    Journal: Ann Thorac Surg; 1996 Dec; 62(6):1691-6; discussion 1696-7. PubMed ID: 8957373.
    Abstract:
    BACKGROUND: Leukocytes are associated with myocardial injury during reperfusion after ischemia. Short periods of leukocyte depletion during reperfusion result in persistent attenuation of postischemic myocardial dysfunction. METHODS: Leukocyte depletion was examined in a canine model of regional myocardial ischemia and reperfusion. The extracorporeal circuit and cardioplegia circuits underwent leukocyte depletion by mechanical filtration. Animals were instrumented for baseline global function before 90-minute occlusion of the left anterior descending coronary artery. Global function during ischemia and at 5, 30, 60, and 90 minutes after a 60-minute cardioplegic arrest using continuous blood cardioplegia was assessed in leukocyte-depleted (n = 9) and control (n = 10) groups. RESULTS: No significant difference between groups was seen for systemic leukocyte counts, global function, or water content. Endothelial function was significantly protected as assessed by response to both calcium ionophore (endothelial-dependent, receptor-independent relaxation: leukocyte-depleted, 72% +/- 19% of endothelin-induced constriction versus control, 46% +/- 14%; p < 0.05) and acetylcholine (endothelial-dependent, receptor-dependent relaxation: leukocyte-depleted, 83% +/- 11% versus control, 44% +/- 15%; p < 0.05). CONCLUSIONS: Leukocyte-mediated endothelial reperfusion injury can be attenuated by leukocyte depletion during reperfusion.
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