Pathways to complement activation during cardiopulmonary bypass

B Collett, A Alhaq, N B Abdullah, L Korjtsas, R J Ware, N J Dodd, E Alimo, J Ponte, D Vergani
1984 BMJ (Clinical Research Edition)  
1251 15 W'hicher J, Bell A, Unwin J, Martin M, IDieppe P. The prostaglandin-induccd acute phase response is defective in endotoxin tolerant mice and in humans with sclerodcrma. Ann?i NY Acad Sci 1982;389:474-5. 16 Schultz D, Macintyre S, Chclladurai M, Kushner I. The role of prostaglandins in the C-reactivc protein rcsponse. Abstract Complement activation was assessed in 34 patients undergoing cardiopulmonary bypass. Arterial concentrations of complement fragments Ba and C3d rose in all
more » ... , the increase in Ba preceding that of C3d. At the same time King's College School of Medicine and Dentistry, London SE5 8RX B COLLETT, MB, FFARCS, senior registrar, department of anaesthetics A ALHAQ, BSC, research assistant (British Heart Foundation) N B ABDDULLAH, MSC, MD, research fellow, department of immunology L KORJTSAS, FIMLS, chief medical laboratory scientific officer, department of haematology R J WARE, MB, FFARCS, consultant, department of anaesthetics N J DODD, MRCP, lecturer, department of haematology E ALIMO, FRCS, MRCP, registrar in cardiothoracic surgery J PONTE, PHD, FFARCS, senior lecturer, department of anaesthetics and intensive care D VERGANI, MD, senior lecturer, department of immunology Correspondence to: Dr J Ponte. as complement fragments were being generated the arterial neutrophil count fell. These findings suggest (a) that complement activation is initiated by the alternative pathway during cardiopulmonary bypass and (b) that complement activation mediates loss of neutrophils during bypass. Complement mediated loss of neutrophils during the analogous setting of haemodialysis is the result of leucosequestration in the pulmonary vasculature. During cardiopulmonary bypass the lungs are out of circuit, so that activated leucocytes may sequester in other target organs. This may be an aetiological factor in the multiorgan failure occasionally seen after uneventful cardiopulmonary bypass.
doi:10.1136/bmj.289.6454.1251 fatcat:vwzqtsazx5fljgm2jrlpfp2qfy