FACTOR-G PATHWAY REACTIVE ACTIVITY (GPRA) AFTER SURGERY FOR ABDOMINALAORTIC-ANEURYSM

Background Following major surgery, detection of endotoxaemia using th e Toxicolor (Limulus) test has been reported. Ln addition to endotoxin s, this test detects a reactant from human tissue, factor G pathway re active activity (GPRA). We measured endotoxin and GPRA in 10 patients during and after elective surgery for abdominal aortic aneurysm. Addit ionally, 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 sp ecimens were taken from the rectus abdominus and homogenized in many l evels. Endotoxin concentrations were measured with the Endotoxin-Speci fic test. GPRA concentrations were determined by subtracting the Value s from the Endotoxin-Specific test from those given by the Toxicolor t est (Limulus assay with achromogenic substrate). CPK was also measured . Results. Endotoxin did not significantly increase during or after su rgery, but GPRA was elevated. GPRA in muscle correlated significantly with CPK in muscle. Conclusions. We conclude that GPRA was elevated af ter surgery, while endotoxin did not increase significantly The GPRA p robably originated from human muscle tissue.