Original Research

Endothelial Progenitor Cell Homing Decreases Postoperative Complications in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass

Lei Du , Wen-Tong Meng , Yu-Jing Zhang , Jie Zhang , Jing Zhou , Jerry Yu , Li-Na Gong , Ke Lin , Lin Bo , Liang Zhao , Jin Liu
Department of Anesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China., Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China., Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu, China., Department of Lab Medicine, West China Hospital, Sichuan University, Chengdu, China., Respiratory, Critical Care and Sleep Disorders Medicine, Department of Medicine, University of Louisville, Louisville, USA., Department of Cardiothoracic Surgery, West China Hospital, Sichuan University, Chengdu, China. Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China.
J Anesth Perioper Med 2014; 1(1): 15- 21 . Published on Sep 9, 2014 . doi:10.24015/JAPM.2014.0004
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Background: Endothelial progenitor cells (EPCs) play an important role in tissue repair, however, their role in reducing complications of cardiac surgery is unclear. This study evaluated the effect of EPCs on cardiac surgery outcomes.

Methods: The prospective, cohort, single central study was conducted in 127 rheumatic heart patients who received valve replacement with cardiopulmonary bypass from June 2009 to June 2011. Circulating EPCs were evaluated perioperatively. Composite surgical outcome was examined during hospital stays.

Results: EPC counts decreased from 42 cells/ml before surgery to 12 cells/ml 4 hours after surgery, although granulocyte colony-stimulating factor significantly increased. The incidence of death, acute respiratory distress syndrome (ARDS), acute renal dysfunction, heart failure occurred less in high EPC homing group (0%, 47.6%, 0%, 0%) than in medium (2.38%, 50%, 2.38%, 2.38%) and low (2.33%, 69.8%, 6.98%, 6.98%) groups. Composite outcome events were also lower in high EPC homing group (P=0.000). Multivariate analysis showed the occurrence of composite outcome events and ARDS was still significantly different among the 3 groups (P=0.007 and P=0.042 respectively). Similarly, the higher pre-surgery EPC was associated with a lower incidence of composite outcome events (P=0.004).

Conclusions: EPC homing occurs during early stages after cardiac surgery, and may help to reduce complications.


Citation: Lei Du, Wen-Tong Meng, Yu-Jing Zhang, Jie Zhang, Jing Zhou, Jerry Yu, et al. Endothelial progenitor cell homing decreases postoperative complications in patients undergoing cardiac surgery with cardiopulmonary bypass. J Anesth Perioper Med 2014; 1: 15-24. doi: 10.24015/JAPM.2014.0004
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