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Related Experiment Videos

Complement activation during cardiopulmonary bypass by heparin-protamine interaction.

N Best, M J Sinosich, B Teisner

    British Journal of Anaesthesia
    |April 1, 1984
    PubMed
    Summary

    Protamine sulfate administration during cardiopulmonary bypass activates the complement system, increasing split products C3d and C3c. This activation, linked to the heparin-protamine complex, showed no adverse clinical effects in patients.

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    Area of Science:

    • Immunology
    • Cardiovascular Surgery

    Background:

    • Cardiopulmonary bypass (CPB) involves complex interactions between blood and artificial surfaces.
    • The complement system, a key part of innate immunity, can be activated during CPB.
    • Protamine sulfate is used to reverse heparin anticoagulation after CPB.

    Purpose of the Study:

    • To investigate the effect of protamine sulfate administration on complement activation markers (C3c and C3d) in patients undergoing CPB.
    • To determine the in vitro mechanism of complement activation by the heparin-protamine complex.

    Main Methods:

    • Measurement of circulating C3c and C3d concentrations in five patients before, during, and after CPB.
    • In vitro experiments to assess complement activation by varying concentrations of the heparin-protamine complex.

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    Main Results:

    • Significant increases in C3d concentrations were observed post-protamine administration.
    • Circulating C3c was detected exclusively in samples taken immediately after protamine administration.
    • In vitro studies confirmed dose-dependent complement activation by the heparin-protamine complex.

    Conclusions:

    • Protamine sulfate administration, particularly the heparin-protamine complex, triggers complement activation.
    • The observed complement activation did not lead to clinically apparent adverse effects in this patient cohort.
    • Further research may explore the clinical implications of this complement activation in CPB settings.