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6th ESACP Congress, Heidelberg, April 7-11, 1999 |
A115
Our initial studies indicate that children who develop post-operative
complications (e.g. capillary leak syndrome, CLS) following cardiac surgery
with cardiopulmonary bypass (CPB) can be predicted based on their
pre-operative level of circulating cytokines and adhesion molecules. The
determination of these values is time consuming and requires a substantial
volume of peripheral blood. Therefore we tested measurement of surface
antigen expression via flow cytometer (FCM) and discriminance analysis as a
potential assay for individual risk assessment of CLS. 24h preoperative blood
samples 49 patients were stained with cocktails of monoclonal antibodies for
the adhesion molecules ICAM-1, LFA1, MAC1, beta-integrin, activation markers
CD25, CD54, CD69, HLA-DR, CD14 or CD4. Cells were measured by 4 color
dual-laser FCM calibrated with microbeads. Antigen expression was detected
considering mean fluorescence intensity of the respective cell population.
The data indicate, that neutrophils of CLS patients express preoperatively
higher levels of LFA1 and monocytes higher levels of HLA-DR and activation
markers. This could lead in combination with surgical trauma and CPB to their
additional stimulation and migration into sites of inflammation and induce
CLS. Using a commercial classifier (SPSS) it was possible to classify 84% of
the patients correctly. It is planned to set up a Flow-Classification program
(CLASSIF1) for individual risk assessment and this would allow for an
individual prophylaxis of post-surgical complications. FCM with its low
sample requirement and rapid access of the results could be a powerful tool
for risk assessment prior to paediatric cardiac surgery. (Supported by the
Deutsche Stiftung fuer Herzforschung).
CHILDREN WITH POST-SURGICAL COMPLICATIONS FOLLOWING CARDIAC SURGERY CAN BE
PREDICTED BY ANTIGEN EXPRESSION ON NEUTROPHILS AND MONOCYTES
Pipek M, Valet G. *, Hambsch J, Schneider P, Tarnok A
Pediatric Cardiology, Heart Centre Leipzig GMBH, University Hospital,
Leipzig, * Max-Planck-Institute für Biochemie, Martinsried, Germany