Total Leukocyte Control (TLC) for Cardiac Surgery

The Total Leukocyte Control (TLC) Program CV Practitioners Can't Afford to Bypass
Leukocyte reducing filters are fairly well accepted to reduce the incidence of white cell-mediated clinical sequelae in the chronically transfused patient population. However, recognition of their value in the acutely transfused patient population, most notably surgery, continues to increase.  (more)


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However, recognition of their value in the acutely tranfused patient population, most notably surgery, is increasing. The open-heart patient can be viewed as one at highest risk for the various types of white-cell-mediated morbidity. Like other surgical patients, subjects of the cardiopulmonary bypass (CPB) procedure are at risk for infectious complications because white cells present in these blood products impart an immunosuppressive effect that can predispose patients to an increased risk of post-operative infections (Van de watering, circulation 1998). Unlike other surgical patients, however, the CPB patient is at risk for complications to the heart and lungs attributable to neutrophil-mediated reperfusion injury. Four types of Pall filters comprise a program of treatment referred to as Total Leukocyte Control (TLC). Recent data suggest that implementation of TLC provides the greatest value to cardiac surgery when compared with a standard of practice that employs steroids as the anti-inflammatory regimen. TLC has been shown to significantly reduce length of hospital stay by 1.4 days and charges by $6,000 per patient in the largest of three risk-stratified groups of patients, the low-risk group (Gott JP, et al: Annals of Thoracic Surgery September, sp 1998).