Effect of aprotinin on the red cell immunity in cardiopulmonary bypass

Abstract

To investigate the effects of aprotinin on red cell (RC) immune function in the patients undergoing cardiopulmonary bypass (CPB), 20 patients who received valve replacement procedure were prospectively studied. The patients were randomly assigned to aprotinin group and control group. Red blood cell C₃b receptor ratio (RC₃bRR), red blood cell immune-component ratio (RICR), plasma C₃, C₄, CH₅₀ and IgG level were determined before operation, at the end of CPB and 1st, 3rd. 7th postoperative days. Our results showed that: (1) The blood requirement was reduced in aprotinin group. (2) After bypass, plasma C₃, C₄, CH₅₀ was maintained in aprotinin group, while they declined in control group. (3) Plasma level IgG fell in both groups, but at 7th postoperative day it recovered in aprotinin group while the level stayed at low level in control group. (4)The RC₃bRR and RICR was mildly inhibited in aprotinin group. It is concluded that the impairment of RC immune function caused by CPB can be mitigated by aprotinin, which may be related to the effects of aprotinin in blood sparing, restriction of complement activation, and reduction of blood requirement which could mitigate the non-specific inflammatory reaction.

Keywords

aprotinin / red cell immunity / cardiopulmonary bypass / heart valve replacement

References

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