Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response
IntroductionThe aim of this study was to investigate the modulatory effect of intraoperative hemoadsorption (HA) versus standard care on the perioperative inflammatory profile of patients undergoing orthotopic heart transplantation (OHT) and its correlation with the severity of post-transplant vasor...
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Frontiers Media S.A.
2025-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1541519/full |
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| author | Hajna Katona Hajna Katona Adam Soltesz Adam Soltesz Eniko Kovacs Eniko Kovacs Zsofia Szakal-Toth Eszter Tamaska Eszter Tamaska Kristof Racz Kristof Racz Tamás Radovits Attila Fintha Krisztián Kovács Lisa Hurler Zoltán Prohászka Bela Merkely Endre Nemeth Endre Nemeth |
| author_facet | Hajna Katona Hajna Katona Adam Soltesz Adam Soltesz Eniko Kovacs Eniko Kovacs Zsofia Szakal-Toth Eszter Tamaska Eszter Tamaska Kristof Racz Kristof Racz Tamás Radovits Attila Fintha Krisztián Kovács Lisa Hurler Zoltán Prohászka Bela Merkely Endre Nemeth Endre Nemeth |
| author_sort | Hajna Katona |
| collection | DOAJ |
| description | IntroductionThe aim of this study was to investigate the modulatory effect of intraoperative hemoadsorption (HA) versus standard care on the perioperative inflammatory profile of patients undergoing orthotopic heart transplantation (OHT) and its correlation with the severity of post-transplant vasoregulatory dysfunction.MethodsIn this secondary analysis, data from NCT03145441, a prospective, single-center, open-label, randomized controlled trial were used.ResultsPatients in the HA group had a lower median vasopressor score, rate of severe vasoregulatory dysfunction (vasopressor score: 19.7 [7.9–37.8] vs. 35.6 [14.5–57.6], p = 0.031, respectively and severe vasoregulatory dysfunction: 33.3% vs. 60.0% p = 0.048, respectively), and reduced procalcitonin (PCT) level (PCT: 0.93 [0.38–2.36] μg/L vs. 2.08 [1.13–6.36] μg/L, p = 0.007, respectively) during the early postoperative period than patients in the control group. The 24-h cytokine and complement levels were comparable in the study groups. The 24-h inflammatory profile of HA and control groups remained unchanged in the cluster of severe vasoregulatory dysfunction. There was a moderate positive correlation between the vasopressor score and the PCT concentration in the control group (rS: 0.605, p = 0.002) which was not identified in the HA group.DiscussionIntraoperative HA treatment exerts a beneficial modulatory effect on the postoperative PCT response in OHT recipients, which is directly associated with significantly lower rates of post-transplant severe vasoregulatory dysfunction compared to controls. |
| format | Article |
| id | doaj-art-e69ce25db4e4471cb3d6e43ac1b4d004 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-e69ce25db4e4471cb3d6e43ac1b4d0042025-08-20T04:00:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.15415191541519Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement responseHajna Katona0Hajna Katona1Adam Soltesz2Adam Soltesz3Eniko Kovacs4Eniko Kovacs5Zsofia Szakal-Toth6Eszter Tamaska7Eszter Tamaska8Kristof Racz9Kristof Racz10Tamás Radovits11Attila Fintha12Krisztián Kovács13Lisa Hurler14Zoltán Prohászka15Bela Merkely16Endre Nemeth17Endre Nemeth18Heart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryDepartment of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, HungaryDepartment of Laboratory Medicine, Semmelweis University, Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, HungaryDepartment of Internal Medicine and Hematology, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryHeart and Vascular Center, Semmelweis University, Budapest, HungaryUniversity Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest, HungaryIntroductionThe aim of this study was to investigate the modulatory effect of intraoperative hemoadsorption (HA) versus standard care on the perioperative inflammatory profile of patients undergoing orthotopic heart transplantation (OHT) and its correlation with the severity of post-transplant vasoregulatory dysfunction.MethodsIn this secondary analysis, data from NCT03145441, a prospective, single-center, open-label, randomized controlled trial were used.ResultsPatients in the HA group had a lower median vasopressor score, rate of severe vasoregulatory dysfunction (vasopressor score: 19.7 [7.9–37.8] vs. 35.6 [14.5–57.6], p = 0.031, respectively and severe vasoregulatory dysfunction: 33.3% vs. 60.0% p = 0.048, respectively), and reduced procalcitonin (PCT) level (PCT: 0.93 [0.38–2.36] μg/L vs. 2.08 [1.13–6.36] μg/L, p = 0.007, respectively) during the early postoperative period than patients in the control group. The 24-h cytokine and complement levels were comparable in the study groups. The 24-h inflammatory profile of HA and control groups remained unchanged in the cluster of severe vasoregulatory dysfunction. There was a moderate positive correlation between the vasopressor score and the PCT concentration in the control group (rS: 0.605, p = 0.002) which was not identified in the HA group.DiscussionIntraoperative HA treatment exerts a beneficial modulatory effect on the postoperative PCT response in OHT recipients, which is directly associated with significantly lower rates of post-transplant severe vasoregulatory dysfunction compared to controls.https://www.frontiersin.org/articles/10.3389/fmed.2025.1541519/fullcomplement systemcytokinesCytoSorbhemoadsorptionheart transplantationprocalcitonin |
| spellingShingle | Hajna Katona Hajna Katona Adam Soltesz Adam Soltesz Eniko Kovacs Eniko Kovacs Zsofia Szakal-Toth Eszter Tamaska Eszter Tamaska Kristof Racz Kristof Racz Tamás Radovits Attila Fintha Krisztián Kovács Lisa Hurler Zoltán Prohászka Bela Merkely Endre Nemeth Endre Nemeth Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response Frontiers in Medicine complement system cytokines CytoSorb hemoadsorption heart transplantation procalcitonin |
| title | Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response |
| title_full | Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response |
| title_fullStr | Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response |
| title_full_unstemmed | Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response |
| title_short | Decreased vasoregulatory dysfunction associated with intra-operative hemoadsorption treatment is related to mitigated post-transplant procalcitonin rather than cytokine or complement response |
| title_sort | decreased vasoregulatory dysfunction associated with intra operative hemoadsorption treatment is related to mitigated post transplant procalcitonin rather than cytokine or complement response |
| topic | complement system cytokines CytoSorb hemoadsorption heart transplantation procalcitonin |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1541519/full |
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