Evidence map›Paper›PMID 40144845›Full record

ArticleJHLT open2025

CytoSorb hemoadsorption of apixaban during cardio-pulmonary bypass for heart transplantation.

Anouk Frering, Antoine Abi Lutfallah, Aude Carillion, Daniel Wendt, Pascal Leprince, Adrien Bougle, Guillaume Lebreton

Abstract read
In one paragraph

Article in JHLT open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Antibiotics and Other Drugs Removal by the CytoSorbAntibiotics (Basel, Switzerland) · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anouk FreringSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Antoine Abi LutfallahSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Aude CarillionSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Daniel WendtCytoSorbents Europe GmbH, Berlin, Germany.
Pascal LeprinceSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Adrien BougleSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Guillaume LebretonSorbonne University, Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Heart transplantation is an emergency surgery requiring cardio-pulmonary bypass (CPB) and its timing is unpredictable. Patients on the transplant waiting list often have multiple reasons for being anticoagulated. Intraoperative removal of apixaban using CytoSorb seems to be an interesting solution for patients on DOACs requiring an emergency CPB intervention. The aim of this short communication is to describe the perioperative effects of the use of the CytoSorb hemoadsorption device during emergency CPB for a heart transplant patient. Methods: A 61-year-old male patient wait-listed for heart transplantation was admitted to our hospital to benefit from a heart transplantation. This patient, has an end-stage heart failure with multiple episodes of decompensation over the previous year. He was anticoagulated with a Vitamin K antagonist (VKA) due to atrial fibrillation and was switched to apixaban. Hemoadsorption by a CytoSorb cartridge was performed during the entire CPB duration. Anti-Factor Xa Activity (AFXaA) levels were taken before, during and after surgery in order to monitor anticoagulation. Results: Surgery consisted of an orthotopic heart transplantation with bi-caval anastomoses. At the time of anesthesia induction and after UFH administration, AFXaA levels were 330ng/mL and 317ng/mL, respectively. Thereafter, AFXaA decreased to 137ng/mL during CPB and to 57ng/mL after the end of CPB and protamine administration. After surgery, AFXaA levels stabilized over 50ng/mL over the next 14 hours. No primary graft dysfunction was observed, and during the post-operative period of 72 hours, the patient did not have any bleeding events requiring reintervention or transfusion. Conclusion: We observed that CytoSorb could be a potential solution to remove apixaban intraoperatively. If this efficacy is confirmed in larger trials, it would allow transplant candidates to be treated with DOACs without requiring a switch to VKAs.

Indexed as

apixabancardio-pulmonary bypassCytoSorbdirect oral anticoagulantsheart transplantationhemoadsorption

Identifiers

PMID40144845
PMCPMC11935314

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.