This retrospective case series included 89 critically ill patients treated with 109 CytoSorb adsorbers. Reasons for treatment included 1. hyperinflammation caused by out of hospital – and in hospital – cardiac arrest, 2. acute respiratory distress syndrome, and both 3. post-cardiotomy and acute-cardiogenic shock. To assess the impact of CytoSorb on two commonly used drugs (the antibiotic vancomycin and the thrombin inhibitor bivalirudin) blood plasma levels were recorded daily and 8 hourly respectively. During treatment with CytoSorb, a decrease in lactate dehydrogenase (LDH, p=0.007), troponin T (p=0.022) and creatine phosphokinase (CPK, p=0.013) was seen. The vancomycin dose required significant adjustments during treatment (p<0.001), but no significant change was necessary after the first 3 days which was similar for the requirements of bivalirudin. Furthermore, it is reported that from a total of 11 patients that were brain dead after extracorporeal cardiopulmonary resuscitation (eCPR) and considered for organ donation, that all transplanted organs (kidneys in 7 patients and liver in 4 patients) showed good functional status after transplant. In conclusion, CytoSorb therapy did not significantly modify the administered dose of vancomycin and bivalirudin after reaching initial stabilization in a large population of severely critically ill patients. The authors conclude that CytoSorb treatment appears to have further application also in the context of organ donation and may be worth further evaluation as an adjunctive tool to reduce ischemic damage and cytokine burden in potential organ donors, as it might contribute to end-organ preservation and ultimately affect outcome. Open-access publication: https://pubmed.ncbi.nlm.nih.gov/33686696/