Issue |
J Extra Corpor Technol
Volume 23, Number 3, September 1991
|
|
---|---|---|
Page(s) | 128 - 133 | |
DOI | https://doi.org/10.1051/ject/1991233128 | |
Published online | 21 August 2023 |
Original Article
Evaluation of Complement Activation on Cardiopulmonary Bypass and in Retransfused Oxygenator and Shed Mediastinal Blood
1
Dept. of Thoracic and Cardiovascular Surgery, University of Berne, 3010 Berne, Switzerland
2
Central Laboratory and Transfusion Services SRC, Berne
3
Hematology, University of Berne, 3010 Berne, Switzerland
* Address correspondence to: B.H. Walpoth, Dept. of Thoracic and Cardiovascular Surgery, Inselspital, 3010 Berne, Switzerland
Several methods of blood salvage are used in cardiac surgery. Our aim was to study, on the basis of complement activation, the quality of autologous blood products reinfused to the patient. Eleven patients with elective myocardial revascularisation were studied for: operative and cardiopulmonary bypass (CPB) data, hematology, blood chemistry and complement activation (C3a [des Arg] and terminal complement complex [TCC] or C5b-9 complex). Centrifugated oxygenator blood (COB) and shed mediastinal blood (SMB) samples were examined before reinfusion into the patient and the effect of this retransfusion on the systemic values.
The activation pattern for C3a [des Arg] and TCC was similar. Thus only evaluation of C3a [des Arg] is reported.
Anesthesia increased C3a [des Arg] two fold over baseline (85 +/- 64 vs. 161 +/-103 ng/ml [standardised]; ns).
Accumulation of complement activation at 1 hr on CPB was 12 fold over baseline for C3a [des Arg]; 1984 +/- 677 ng/ml [standardised]; p< 0.01).
C3a [des Arg] in COB and in SMB were 5002 +/- 2027 and 4910 +/-1985 ng/ml [standardised], respectively.
However, after retransfusion of each autologous blood product no further increase in anaphylatoxin concentration could be detected in the patient's blood.
We conclude that despite complement activation in reinfused autologous blood products no further increase is seen in the patient's circulation. This is explained either by the very potent clearing capacity of the body or the rapid absorption of C3a [des Arg] by cellular receptors.
© 1991 AMSECT
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