Hirudin Protects from Leukocyte/Endothelial Cell Interaction Induced by Extracorporeal Circulation*

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Abstract
Background: The clinical complications of Extracorporeal Circulation (ECC) have been linked to disturbances in the microcirculation. In order to prevent these deleterious effects, a biodegradeable agent to coat the extracorporeal circuit was tested. Methods: Intravital fluorescence microscopy was used on the hamster skinfold chamber model in permanently instrumented, awake animals. ECC was introduced via a micro-roller-pump and a silicon tube shunted between the carotid artery and the jugular vein. The ECC-tube system was coated with PEG-Hirudin-Iloprost, two additional groups received either Iloprost i. v. (0,8 mg/kg/h) or Hirudin i. v. (1 mg/kg b. w.). Results: ECC for 20 minutes resulted in an increase in rolling and adherent leukocytes in postcapillary venules (Roller 9 to 36 [%]; Sticker 24 to 330 [n/mm2]). Use of the coated tube system reduced L/E cell interaction (Roller 9 to 24* [%], Sticker 28 to 194* [n/mm2]; *p < 0.05), whereas Hirudin i. v. nearly abolished it. Conclusions: The protective effects of the coating and of Hirudin i. v are probably a result of an attenuated activation of the coagulation-fibrinolytic system. 1 *Results were presented in part at the 3rd Joint meeting of the German, the Austrian and the Swiss Societies for Thoracic and Cardiovascular Surgery, February 2000 in Lucerne, CH.

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