Factor G pathway reactive activity (GPRA) after surgery for abdominal aortic aneurysm.
BACKGROUND
Following major surgery, detection of endotoxaemia using the Toxicolor (Limulus) test has been reported. In addition to endotoxins, this test detects a reactant from human tissue, factor G pathway reactive activity (GPRA). We measured endotoxin and GPRA in 10 patients during and after elective surgery for abdominal aortic aneurysm. Additionally, we measured phosphokinase (CPK) and GPRA levels in the muscle of 10 patients during abdominal aortic aneurysm surgery and 6 during open laparotomy for other causes.


METHODS
Samples were taken from the arterial lines prior to surgery, before cross-clamping of the aorta, immediately after and 1, 3, 6, and 18 hours after declamping. Muscle specimens were taken from the rectus abdominus and homogenized in many levels. Endotoxin concentrations were measured with the Endotoxin-Specific test. GPRA concentrations were determined by subtracting the values from the Endotoxin-Specific test from those given by the Toxicolor test (Limulus assay with achromogenic substrate). CPK was also measured.


RESULTS
Endotoxin did not significantly increase during or after surgery, but GPRA was elevated. GPRA in muscle correlated significantly with CPK in muscle.


CONCLUSIONS
We conclude that GPRA was elevated after surgery, while endotoxin did not increase significantly. The GPRA probably originated from human muscle tissue.
Sugita
T
T
Second Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Watarida
S
S
Katsuyama
K
K
Nakajima
Y
Y
Yamamoto
R
R
Mori
A
A
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000601:surgery*; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood; D019446:Endotoxemia / Q000175:diagnosis*; D006801:Humans; D008033:Limulus Test; D018482:Muscle, Skeletal / Q000378:metabolism
D003402:Creatine Kinase