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Perioperative changes in complement associated with cardiopulmonary bypass

H Boralessa, J A Shifferli, F Zaimi

    British Journal of Anaesthesia
    |October 1, 1982
    PubMed
    Summary
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    Complement levels (CH50, C3, C4) decreased during and after cardiopulmonary bypass. These changes were likely due to non-specific protein alterations, not complement activation, with transferrin levels supporting an acute phase response.

    Area of Science:

    • Immunology
    • Cardiovascular Surgery

    Background:

    • Cardiopulmonary bypass (CPB) can activate the complement system.
    • Understanding complement behavior during CPB is crucial for patient outcomes.

    Purpose of the Study:

    • To investigate the changes in complement system components (CH50, C3, C4, C3d) and transferrin during and after CPB.
    • To determine if observed complement depletions are indicative of complement activation.

    Main Methods:

    • Measurements of total hemolytic complement (CH50), C3, C4, C3d, and transferrin.
    • Analysis of samples collected before, during, and at multiple time points after CPB.

    Main Results:

    • CH50 decreased post-heparinization and remained low throughout and after CPB.

    Related Experiment Videos

  • C3 and C4 levels significantly decreased during CPB and for 8 hours post-CPB, then gradually increased.
  • No significant increase in C3d was observed, indicating complement depletions were not due to activation.

    • Conclusions:

    • Complement depletions during CPB are unlikely to result from complement activation.
    • Non-specific protein concentration changes (dilution, redistribution) are probable causes for observed reductions.
    • The post-operative increase in C3 and C4 may be linked to the acute phase response, supported by decreased transferrin levels.