J.Jpn. Surg. Soc.. 93(2): 189-196, 1992

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Original article

FUNDAMENTAL AND CLINICAL STUDIES OF HOMOLOGOUS IMMUNOGLOBULIN-FREE PRIMING IN CARDIOPULMONARY BYPASS, WITH SPECIAL REFERENCE TO ANAPHYLATOXIN PRODUCTION

In in-vitro study, human immunoglobulin (Ig) denatured by O₂ bubbling markedly produced C4_a, C3_a, and C5_a, whereas human albumin treated identically did not. White blood cells (WBC) treated by O₂ bubbling significantly increased C3_a levels alone, but at a much lesser grade than the Ig. A new priming method, i.e., homologous concentrated red cell (CRC) and human albumin was discerned from the experimental facts in-vitro, and we investigated the clinical effects of that priming method. C4_a, C3_a, and C5_a in BOG primed with homologous whole blood (HWB) were slightly higher than those in MOG during CPB. Those in the Ig-free priming group were more mildly increased than those in the HWB priming group, not only during CPB, but also after protamine administration; this tendency was clearer in BOG. It is concluded that (1) human immunoglobulin (Ig) denatured by O₂ bubbling produces anaphylatoxins via the classical pathway; (2) WBC treated identically produces C3a at a far milder grade; (3) priming with CRC and human albumin reduces plasma anaphlatoxin levels; and (4) pulmonary function at an early postoperative period was improved in the homologous Ig-free priming group, especially with BOG.

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