Current brands available - advantages & disadvantages

1. Pall Leukogard 6

a) Activated leukocyte depleting polyester

b) 40 m polyester screen

c) Automatic gas venting

d) Arterial line filter

2. Pall leucocyte depleting blood cardioplegia filter

a) Combines leucocyte depletion filtration with more conventional gaseous & particulate microemboli 40 m screen

b) Depletes cardioplegia blood of circulating leucocytes

c) Efficiency of leucocyte removal is dependent upon

i) Volume of blood cardioplegia delivered

ii) Conditions under which the blood cardioplegia is administered

d) Can handle flow rates of up to 500ml/min

3. Pall RC400 rapid flow blood transfusion leucocyte removal filter

a) More effective at removing leucocytes (not just activated leucocytes as in arterial filters)

b) But also removes up to 10% of rbc

· May reduce inflammatory response, but are expensive

Use of leucocyte filters in both bank blood filters & CPB arterial filters

1. Removal of leucocytes, activated leucocytes (esp neutrophils)

a) CPB

i) Mediators of inflammatory damage associated with CPB

ii) Filtration results in reduction of ventilation times

iii) Leucocyte adherence to capillary endothelium has been linked to alveolar cell damage

b) Transfused blood

i) Immunosuppression

ii) Cytomegalovirus transmission

a) CMV resides in leucocytes

c) Cardioplegia

i) Implicated in reperfusion injuries

ii) Reduction in leukocyte mediated oxidant damage

2. Types of Leucocyte depleting filters

a) Arterial line filter

b) Cardioplegia filter

c) Blood transfusion filters

Efficiency, rate of infusion, typical lifespan of the various kinds of filter

1. Pall leucocyte depleting blood cardioplegia filter

a) Combines leucocyte depletion filtration with more conventional gaseous & particulate microemboli 40 m screen

b) Depletes cardioplegia blood of circulating leucocytes

c) Efficiency of leucocyte removal is dependent upon

i) Volume of blood cardioplegia delivered

ii) Conditions under which the blood cardioplegia is administered

d) Can handle flow rates of up to 500ml/min

2. Pall RC400 rapid flow blood transfusion leucocyte removal filter

a) More effective at removing leucocytes (not just activated leucocytes as in arterial filters)

b) But also removes up to 10% of rbc

3. Pall Leukogard 6

a) ? removes only activated leucocytes

4. Mechanism of leukocyte removal