Haemolysis-induced acute kidney injury resulting from cardiac surgery: evaluation of haemoglobin and related product removal therapeutic approaches (Mr Karl Riley)

New literature indicates that the decompartmentalisation of haemoglobin, haem and iron contributes systemic inflammation in post-operative cardiopulmonary-bypass (CPB) patients.

The onset of acute kidney injury is a prominent linked post-operative complication in this population as is acute lung injury. Removing the products of haemolysis from the cardiopulmonary bypass circuit is an obvious therapeutic option.

This study will investigate usage of a filter to target and remove these products of haemolysis, in an in vivo model of CPB, will further examine mechanistic effects and benefits for vascular endothelial cells and will also examine relationships between haemolysis and outcomes in patient cohorts.

The inline filter comprising immoblised haptoglobin, albumin and desferrioxamine to remove Hb, haem and iron respectively from the circulation is proposed. A prototype has been developed and a European patent granted.

Testing the absorption efficacy and efficacy with in vivo models of CPB will be undertaken together an exploration of benefits of these haemolysis removal strategies at the level of relevant vascular endothelial cells using human blood and patient blood samples.