Effects of extracorporeal circulation and heparin on the phenotype of platelet surface antigens following heart surgery.
In this prospective study, the time-dependent effects of extracorporeal circulation and heparin-mediated effects on platelet surface antigens in vitro were investigated using whole blood flow cytometry. Blood samples were drawn prior to and following extracorporeal circulation in 89 patients. The response of surface antigen expression (glycoprotein IIb/IIIa, P-selectin, and glycoprotein Ib) with and without in vitro stimulation was measured. A significant correlation of the duration of extracorporeal circulation with the postoperative response of glycoprotein IIb/IIIa, glycoprotein Ib, and P-selectin to in vitro activation was found. Postoperative P-selectin and glycoprotein Ib expression stimulated with ADP correlated to blood loss. Heparin in vitro significantly reduced glycoprotein Ib expression. Heparin, as well as the duration of extracorporeal circulation, independently correlated to phenotypic changes of platelets following extracorporeal circulation. The significant correlation of these variables to postoperative blood loss demonstrates their relevance to platelet function in vivo.
Wahba
A
A
Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany. awahba@gmx.net
Rothe
G
G
Lodes
H
H
Barlage
S
S
Schmitz
G
G
Birnbaum
D E
DE
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D005112:Extracorporeal Circulation; D005434:Flow Cytometry; D006493:Heparin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D016130:Immunophenotyping; D008875:Middle Aged; D019007:P-Selectin / Q000096:biosynthesis / Q000187:drug effects; D010446:Peptide Fragments / Q000494:pharmacology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000096:biosynthesis / Q000187:drug effects; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000096:biosynthesis / Q000187:drug effects; D010980:Platelet Membrane Glycoproteins / Q000096:biosynthesis / Q000187:drug effects*; D011446:Prospective Studies; D013997:Time Factors
D000925:Anticoagulants; D019007:P-Selectin; D010446:Peptide Fragments; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019038:Platelet Glycoprotein GPIb-IX Complex; D010980:Platelet Membrane Glycoproteins; C082835:thrombin receptor peptide (42-47); D000244:Adenosine Diphosphate; D006493:Heparin