J.Jpn. Surg. Soc.. 81(6): 468-480, 1980

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Original article

ROLE OF HAPTOGLOBIN PREPARATION IN OPEN HEART SURGERY

Haptoglobin, a trace component of plasma, combines with hemoglobin liverated from red blood cells broken in the blood vessels. However, when massive hemolysis occurs in a short period, all of the haptoglobin contained in the physiological plasma is consumed. Thereafter, haptoglobin-hemoglobin complex cannot be made and free-hemoglobin increases in the plasma. These phenomena are clinically found in extreme burns, massive blood transfusion and imcompatible blood transfusion. In open heart surgery, prolonged extracorporeal circulation will produce massive hemolysis, that is one of the most common cause of various complications in postoperative period.
Haptoglobin preparation, isolated form human plasma, was administrated for experimental animals and patients in extncorporeal circulation. In animal experiments, the following conclusion was reached.
1) With the administration of haptoglobin preparation, hemoglobinuria and hemoglobin in ascitas were prenented in all the animals, and 2) hemosiderosis in the renal tubuli and hepatic cells were prevented.
In carefull administration of haptoglobin for the patients in open heart surgery, the conclusion is as follows:
1) With the administration of haptoglobin preparation, hemoglobinuria was prevented or reduced completely in all the patients, 2) It was comfirmed that free-hemoglobin, liberated form injured red cells, combined immediately and firmly with administrated haptoglobin. Excretion of hemoglobin in urine did not occur because haptoglobin-hemoglobin complex cannot pass through the glomeruli.
3) Haptoglobin-Hemoglobin complex is catabolized in the parenchimal cells of the liver. Administration of haptoglobin preparation is resulted in extraordinary accumulation of haptoglobin-hemoglo bin complex in circulating plasma. However, such load of haptoglobin-hemoglobin complex on the hepatic cells did not injure the hepatic parenchimal cells, neither increased the values of serum enzymes.
4) As to the administration of the preparation, serum creatinine as an index of renal function was decreased in administrated patients, compared with non-administrated patients, but the result is not significant statistically.

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