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Related Experiment Videos

Specific complement inhibition with heparin-coated extracorporeal circuits

H te Velthuis1, P G Jansen, C E Hack

  • 1Centre for Cardiopulmonary Surgery Amsterdam, The Netherlands.

The Annals of Thoracic Surgery
|April 1, 1996
PubMed
Summary

Heparin-coated circuits reduce complement activation during heart surgery, specifically the alternative and terminal pathways. This suggests C3b/c is a better marker than C3a for assessing complement activation.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Immunology

Background:

  • Heparin-coated circuits are known to reduce complement activation in cardiac surgery.
  • Limited in vivo data exists on their impact on alternative and classic complement pathways.

Purpose of the Study:

  • To compare complement activation in patients undergoing coronary artery bypass grafting using heparin-coated versus uncoated extracorporeal circuits.
  • To assess alternative, classic, and terminal complement pathway activation in vivo.

Main Methods:

  • Prospective, randomized study of 20 patients undergoing coronary artery bypass grafting.
  • Comparison of heparin-coated (Duraflo II) circuits with uncoated circuits.
  • Measurement of complement activation products: iC3, C4b/c, soluble C5b-9, C3a, and C3b/c.

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Main Results:

  • Heparin-coated circuits significantly reduced C3b/c and soluble C5b-9 concentrations post-cardiopulmonary bypass.
  • No significant reduction was observed in iC3, C4b/c, or C3a concentrations.
  • Reductions were sustained after protamine sulfate administration.

Conclusions:

  • Heparin-coated circuits effectively reduce alternative complement pathway activation at the C3 convertase level.
  • This leads to downstream reduction in terminal complement pathway activation.
  • C3b/c is a more sensitive marker than C3a for assessing complement activation during cardiac operations.