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Complement and leukocyte changes during major vascular surgery.

F Knudsen1, P T Andersen, L K Nielsen

  • 1Departments of Anesthesia, Clinical Chemistry, and Clinical Immunology, Aalborg Hospital, Denmark.

Journal of Cardiothoracic Anesthesia
|October 1, 1988
PubMed
Summary
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Major abdominal aortic surgery without blood transfusion did not activate complement. Leukocyte counts and granulocyte elastase increased post-declamping, suggesting these may be linked to aortic cross-clamping or prosthesis interaction.

Area of Science:

  • Vascular Surgery
  • Immunology
  • Hematology

Background:

  • Major vascular surgery, particularly involving the abdominal aorta, can impact the immune system.
  • Previous studies suggested complement activation during aortic surgery, potentially due to blood product administration.

Purpose of the Study:

  • To investigate the effects of abdominal aortic surgery on complement activation and leukocyte responses.
  • To differentiate the roles of aortic cross-clamping versus blood products in immune modulation during surgery.

Main Methods:

  • Serial measurements of leukocyte and differential counts.
  • Plasma concentrations of C3d (a complement activation marker) were measured.
  • Plasma concentrations of granulocyte elastase bound to alpha1 proteinase inhibitor (E-alpha1PI) were assessed post-aorta declamping.

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Main Results:

  • Lymphocyte counts decreased in the hours after aorta declamping.
  • Total leukocytes, neutrophils, and plasma E-alpha1PI levels increased post-declamping.
  • No evidence of complement activation was detected in patients not receiving blood or plasma.

Conclusions:

  • Major abdominal aortic surgery in patients not receiving blood or plasma does not appear to activate the complement system.
  • The observed increase in leukocytes and E-alpha1PI may be associated with aortic cross-clamping or granulocyte-aortic prosthesis interactions.
  • Further research is needed to clarify the mechanisms behind lysosomal enzyme release during aortic procedures.