Continuous venovenous hemofiltration after cardiac valve replacement

doi:10.3969/j.issn.2095-4344.2014.05.010

Abstract

Abstract:

BACKGROUND: Abnormal immunological function is possibly observed after cardiac valve replacement. However, effect of continuous venovenous hemofiltration on immunological function after cardiac valve replacement is rarely reported.

OBJECTIVE: To observe the effect of continuous venovenous hemofiltration on the cellular immune function in patients with multiple organ dysfunction syndrome after cardiac valve replacement.

METHODS: Thirty-one patients with multiple organ dysfunction syndrome after cardiac valve replacement in Xijing Hospital, the Fourth Military Medical University of Chinese PLA, from August 2008 to July 2009, were included in this study. They were treated with continuous venovenous hemofiltration using AV600 hemofilter and were divided into two groups: survival group (17 survivors) and death group (14 deaths). In addition, 16 healthy blood donors served as the control group.

RESULTS AND CONCLUSION: The duration of acute renal failure before continuous venovenous hemofiltration of survival group was significantly lower than that of death group (P < 0.05). Before continuous venovenous hemofiltration, the CD4⁺/CD8⁺ ratio and Th1/Th2 ratio of survival group and death group were lower than that of control group (P < 0.05), and lymphocyte apoptosis rate and Fas/FasL antigen expression were higher than that of control group (P < 0.05). This evidence suggested the presence of immunosuppression state and Th1/Th2 disbalance. During continuous venovenous hemofiltration, the CD4⁺/CD8⁺ ratio and Th1/Th2 ratio of survival group were gradually increased (P < 0.05), while lymphocyte apoptosis rate and Fas/FasL antigen expression were gradually decreased (P < 0.05) at 24 hours. The above changes were observed in both survival group and death group, but emerged latter in death group. Continuous venovenous hemofiltration can improve cellular immune function, maintain the balance of T lymphocyte subsets and Th1/Th2, down-regulate Fas/FasL expression on the surface of lymphocyte membrane, and decrease lymphocyte apoptosis rate in patients with multiple organ dysfunction syndrome after cardiac valve replacement. Early continuous venovenous hemofiltration can improve patients’ prognosis.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: cardiac valve, cardiac valve graft implantation, hemofiltration, multiple organ dysfunction syndrome, extracorporeal circulation, immune system

CLC Number:

R318

Zhao Xiao-juan, Liu Hong-bao, Sun Shi-ren, Zhang Peng, Wang Han-min, Huang Chen . Continuous venovenous hemofiltration after cardiac valve replacement[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(5): 712-717.

Figures/Tables 4

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