title: Perioperative Elevation in Cell-Free DNA Levels in Patients Undergoing Cardiac Surgery: Possible Contribution of Neutrophil Extracellular Traps to Perioperative Renal Dysfunction.
abstract: Background. This study aimed to determine the perioperative change in serum double-strand DNA (dsDNA) as a marker potentially reflecting neutrophil extracellular trap concentration in samples from patients undergoing cardiac surgery and to analyze a relationship between serum dsDNA concentrations and perioperative renal dysfunction.Methods. Serum dsDNA concentrations in samples that were collected during a previously conducted, prospective, multicenter, observational study were measured. Eighty patients undergoing elective cardiac surgery were studied. Serum samples were collected at baseline, immediately after surgery, and the day after surgery (POD-1).Results. Serum dsDNA concentration was significantly increased from baseline (median, 398 ng/mL [interquartile range, 372-475 ng/mL]) to immediately after surgery (median, 540 ng/mL [437-682 ng/mL],p< 0.001), and they were reduced by POD-1 (median, 323 ng/mL [256-436 ng/mL]). The difference in serum creatinine concentration between baseline and POD-1 was correlated with dsDNA concentration on POD-1 (rs= 0.61,p< 0.001).Conclusions. In patients undergoing cardiac surgery, serum dsDNA concentration is elevated postoperatively. Prolonged elevation in dsDNA concentration is correlated with perioperative renal dysfunction. Further large-scale studies are needed to determine the relationship between serum concentration of circulating dsDNA and perioperative renal dysfunction.
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Tokujiro
authors.identifier: 0000-0002-9474-0020
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Yudai
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kido
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Anesthesiology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Nagara
authors.initials: N
authors.lastname: Ohno
authors.affiliation: Department of Anesthesiology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Asahara
authors.affiliation: Department of Anesthesiology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Critical Care Medicine, Yokohama City University Medical Center, Kanagawa, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamaguchi
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Mitaka
authors.affiliation: Clinical Research Center, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tomita
authors.affiliation: Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.
authors.forename: Koshi
authors.initials: K
authors.lastname: Makita