What does this research mean for the field?

Intraoperative hemoadsorption during surgery for Stanford Type A Aortic Dissection is associated with shorter ICU stays and significantly lower postoperative levels of aspartate aminotransferase and alanine transaminase. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To observe the clinical effects and laboratory changes associated with intraoperative hemoadsorption in patients undergoing surgery for Stanford Type A Aortic Dissection.

June 11, 2026Journal of Cardiothoracic SurgeryOpen Access

The effect of hemoadsorption to patients with Stanford Type A Aortic Dissection

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Stanford Type A Aortic Dissection (n=100). Intervention: Hemoadsorption during cardiopulmonary bypass vs. Regular cardiopulmonary bypass without hemoadsorption. Primary outcome: ICU stay ≤ 6 days (p=0.038).

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Key result

Intraoperative hemoadsorption during CPB linked to ~18-point increase in shorter ICU stays.

P=0.038
n=100

Why the study?

Hemoadsorption is an emerging therapy potentially valuable in blood purification, inflammation inhibition, and toxin removal, but its effects in patients with Stanford Type A Aortic Dissection required observation.

Does intraoperative hemoadsorption improve clinical outcomes and organ function markers in patients undergoing surgery for Stanford Type A Aortic Dissection?

Key Points

To observe the clinical effects and laboratory changes associated with intraoperative hemoadsorption in patients undergoing surgery for Stanford Type A Aortic Dissection.
Retrospectively analyzed clinical data of 100 patients with Stanford Type A Aortic Dissection treated between January 2021 and June 2023.
Patients were allocated to either the hemoadsorption group (HA, n = 50) using the HA-380 cartridge during cardiopulmonary bypass or the control group (CON, n = 50).
Compared surgical parameters, primary clinical endpoints, and laboratory markers including liver and renal function tests at 24 h and 48 h postoperatively.
A significantly higher proportion of patients had an ICU stay ≤ 6 d in the HA group compared to the CON group (84.0% [42/50] vs 66.0% [33/50], P = 0.038), whereas overall hospital stay was 21.6 ± 8.4 d versus 23.2 ± 11.3 d (P = 0.419).
Postoperative ALT levels were significantly lower in the HA group at 24 h (32.1 vs 45.9 U/L; ratio 0.70, 95% CI 0.55–0.90, P = 0.006) and 48 h (36.9 vs 52.8 U/L; ratio 0.70, 95% CI 0.55–0.90, P = 0.006).
Postoperative AST levels were significantly lower in the HA group at 24 h (85.7 vs 132.1 U/L; ratio 0.65, 95% CI 0.50–0.84, P = 0.001) and 48 h (69.3 vs 107.9 U/L; ratio 0.65, 95% CI 0.50–0.83, P = 0.001).

Study Design

Type

Cohort (n=100)

Multicenter

Structured PICO

Does intraoperative hemoadsorption improve clinical outcomes and organ function markers in patients undergoing surgery for Stanford Type A Aortic Dissection?

Population

100 adult patients with Stanford Type A Aortic Dissection undergoing surgical repair were retrospectively analyzed to observe the effect of intraoperative hemoadsorption.

Exposure

Hemoadsorption (HA-380 cartridge, Jafron Biomedical) connected within the circuit and used continuously during the entire cardiopulmonary bypass (CPB) period (preconditioned by heparin, blood flow 400-500 ml/min, target ACT ≥ 480s), temporarily stopped during deep hypothermia circulatory arrest.

Comparator

Regular cardiopulmonary bypass (CPB) without hemoadsorption.

Outcome

Postoperative awaking ≤ 10 h, postoperative extubation ≤ 48 h, postoperative CRRT, postoperative reintubation, ICU stay ≤ 6 d and hospital stay.

Main Result

Absolute Event Rate: 84% vs 66%

p-value: p=0.038

Intraoperative hemoadsorption during cardiopulmonary bypass for Stanford Type A Aortic Dissection may increase the rate of short ICU stays and attenuate early postoperative hepatocellular injury, though renal protection was not demonstrated.

Limitations

Retrospective analysis from a single center with small sample size
Selection bias towards hemodynamically stable patients
Lack of inflammatory factor assays like IL-6 and TNF-α
Surgical complexity variables not collected
Hemoadsorption related-adverse events not fully summarized
Retrospective analysis from a single center with a relatively small sample size
Selection bias due to initial cautious use preferring hemodynamically stable patients
Lack of comprehensive observational variables, specifically missing inflammatory markers like IL-6 and TNF-α
Potential confounding from unadjusted surgical complexity variables (e.g., ascending aorta vs total arch replacement)
Hemoadsorption-related adverse events such as thrombocytopenia were not fully summarized

Implication

May support shorter ICU stays in TAAD surgery; hypothesis-generating and requires RCTs before practice change.

Abstract

OBJECTIVE: To observe the effect of hemoadsorption, an emerging therapy potentially valuable in blood purification, inflammation inhibition and toxic removal, to patients with Stanford Type A Aortic Dissection. METHODS: The clinical data of 100 patients with TAAD from January 2021 to June 2023 were retrospectively analyzed. Patients were divided into HA group and CON group, depending on the usage of hemoadsorption during the cardiopulmonary bypass, with 50 patients in each group. The comparison between two groups was performed including cardiopulmonary time, surgery time, aortic cross-clamp time, deep hypothermia cardiac arrest time, ultrafiltration volume, urine output as well as blood transfusion and clinical laboratory tests such as white cell count, aspartate aminotransferase, alanine transaminase, creatinine as well as blood urea nitrogen. All these variables were measured at 24 h and 48 h after surgery. RESULTS: There was no significant difference for both baseline characteristics and surgery-related variables between two groups (P > 0.05). The number of patients with ICU stay ≤ 6 d in HA group was higher significantly than that in CON group (P = 0.038), while, other remaining endpoints were not significant in two groups (P > 0.05). Postoperative 24 h and 48 h, lower aspartate aminotransferase and alanine transaminase are associated with intraoperative hemoadsorption (P = 0.006, 0.006, 0.001 and 0.001, respectively). CONCLUSION: Hemoadsorption is correlated with early positive and favorable changes of laboratory tests.

Discussion

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Published by Journal of Cardiothoracic Surgery · CC BY-NC-ND

Cite This Study

Liu et al. (2026) conducted a cohort in Stanford Type A Aortic Dissection (n=100). Hemoadsorption during cardiopulmonary bypass vs. Regular cardiopulmonary bypass without hemoadsorption was evaluated on ICU stay ≤ 6 days (p=0.038). Intraoperative hemoadsorption during cardiopulmonary bypass significantly increased the proportion of patients with an ICU stay ≤ 6 days compared to standard bypass (84.0% vs 66.0%, p=0.038).

synapsesocial.com/papers/6a2a4fa380c8f91e7f39c919 https://doi.org/10.1186/s13019-026-04348-7

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Implication

May support shorter ICU stays in TAAD surgery; hypothesis-generating and requires RCTs before practice change.

The effect of hemoadsorption to patients with Stanford Type A Aortic Dissection

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

The effect of hemoadsorption to patients with Stanford Type A Aortic Dissection

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Figures from the paper

Cite This Study

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