Utjecaj Cytosorb hemofiltera na ishode transplantacije srca

master's thesis

• Title (english): Impact of Cytosorb hemofilter on heart transplant outcomes
• Author: Sarah Singer
• Mentor: Igor Rudež (mentor)
• Committee member: Davor Mijatović (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Igor Rudež (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2023-09-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Cilj istraživanja. Istraživanje ispituje hipotezu da Cytosorb hemofilter smanjuje potrebu za transfuzijama krvnih derivata tijekom i nakon transplantacije srca. Ciljevi uključuju usporedbu transfuzijskih potreba i trajanja ekstrakorporalne cirkulacije između skupina s i bez Cytosorba, te analizu ISHLT score-ova i znakova odbacivanja.

Ispitanici i metode. Retrospektivna kohortna studija provedena na 81 pacijenta podvrgnutog transplantaciji srca u Kliničkoj bolnici Dubrava, podijeljenih u dvije skupine: jedna s Cytosorbom (40) i jedna bez (41).

Rezultati. U istraživanju, primjena Cytosorb hemofiltera značajno je smanjila potrebu za transfuzijama eritrocitnih koncentrata u postoperativnom razdoblju, što može imati pozitivan utjecaj na ishode transplantacije srca. Ipak, primijećena je povećana upotreba krioprecipitata u Cytosorb skupini, što može biti jedan od razloga smanjene potrebe za transfuzijama eritrocita. Iako je zabilježeno produljeno vrijeme srčane ishemije u skupini tretiranoj Cytosorbom, nije bilo klinički značajnih posljedica, čak i uz lošije početne ISHLT score-ove, ukazujući na mogući zaštitni učinak Cytosorba u ranim posttransplantacijskim fazama.

Zaključak. Cytosorb smanjuje potrebu za određenim transfuzijama, ali uz složene efekte poput produljenog vremena ishemije. Rezultati su obećavajući, ali zahtijevaju daljnja istraživanja za potvrdu učinkovitosti i sigurnosti.

Abstract (english)

Objective. The research tests the hypothesis that the Cytosorb hemofilter reduces the need for transfusions of blood derivatives during and after heart transplantation. The objectives include comparing transfusion needs and the duration of extracorporeal circulation between groups with and without Cytosorb, as well as analyzing ISHLT scores and signs of rejection.

Subjects and methods. A retrospective cohort study was conducted on 81 heart transplant patients at the Clinical Hospital Dubrava, divided into two groups: one with Cytosorb (40) and one without (41).

Results. In the study, the use of the Cytosorb hemofilter significantly reduced the need for erythrocyte concentrate transfusions in the post-operative period, which can have a positive impact on heart transplant outcomes. However, an increased use of cryoprecipitate was noted in the Cytosorb group, which might be one of the reasons for the reduced need for erythrocyte transfusions. Although an extended cardiac ischemia time was observed in the group treated with Cytosorb, there were no clinically significant consequences, even with poorer initial ISHLT scores, indicating a possible protective effect of Cytosorb in the early post - transplantation phases.

Conclusion. Cytosorb reduces the need for certain transfusions, but with complex effects such as prolonged ischemia time. The results are promising but require further research to confirm efficacy and safety.

• Keywords: Transplantacija srca; Cytosorb; Zatajivanje srca
• Keywords (english): Heart Transplantation; Cytosorb; Heart Failure
• Language: croatian
• URN:NBN: urn:nbn:hr:105:631918
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-31 09:14:05