In this letter to the editor, 6 patients received CytoSorb following admission to the intensive care unit (ICU) post lung transplantation (fibrosis – 4, chronic obstructive pulmonary disease – 1, silicosis – 1). CytoSorb was integrated into the extracorporeal membrane oxygenation (ECMO) circuit and ran for 24 hrs. Blood samples were collected before CytoSorb was installed (T0), after 24 hrs of treatment (T1), and 24 hours after cessation of treatment (T2). Membrane activation markers of neutrophils (CD66b and CD11b), monocytes (CD14 and HLA-DR), interleukin – IL6 and IL 8 and coagulation factors and lactate were collected. At T2 CD66B and CD11b were significantly decreased, as was lactate, with a downward trend noted for all other markers. The decrease in neutrophil and monocyte activation markers suggests a possible indirect immunomodulatory effect on phagocyte activation. The three patients with elevated IL-6 and/or IL-8 levels at T0 experienced a dramatic decrease at T1. There was no rebound effect at T2. Coagulation markers remain unaltered. Norepinephrine doses improved as did the P/F ratio during CytoSorb treatment (so between T0 and T1). When compared to a ‘control’ group of 27 transplant pts, the ICU and hospital lengths of stay were longer for the CytoSorb group, however at year 1 after transplant, all the CytoSorb patients were alive, whereas the survival rate for the control group was 70.4%. The authors conclude that CytoSorb appears to be a safe and promising device to fight post lung transplant inflammation.
Open-access publication: https://pubmed.ncbi.nlm.nih.gov/35387399/