Review of Interleukin-6 and Cardiopulmonary Bypass-Related End-Organ Injury Along With the Potential for Mitigation With Tocilizumab

World J Pediatr Congenit Heart Surg. 2025 May;16(3):395-401. doi: 10.1177/21501351241285449. Epub 2024 Oct 25.

Abstract

Cardiopulmonary bypass (CPB) is essential for the conduct of open-heart procedures. While lifesaving, CPB can be associated with significant end-organ injuries believed to result from inflammatory responses triggered by the extracorporeal surfaces encountering cellular elements in the blood stream. In this review, we discuss the role of interleukin-6 (IL-6) and the potential for Tocilizumab, an anti-IL-6 receptor antibody, in mitigating these effects. We compare the inflammatory responses in CPB and cytokine storm, a clinical condition in which Tocilizumab has been effectively implemented. Finally, we examine why corticosteroids, used to reduce the morbidity of CPB, may not effectively reduce IL-6 levels.

Keywords: Tocilizumab; cardiopulmonary bypass (CPB); congenital heart disease; inflammation; interleukin 6 (IL-6); pediatric heart surgery.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Cardiopulmonary Bypass* / adverse effects
  • Cytokine Release Syndrome* / drug therapy
  • Cytokine Release Syndrome* / etiology
  • Cytokine Release Syndrome* / prevention & control
  • Humans
  • Interleukin-6 Inhibitors*
  • Interleukin-6* / blood

Substances

  • Antibodies, Monoclonal, Humanized
  • Interleukin-6
  • Interleukin-6 Inhibitors
  • tocilizumab