Effects of dextrans on the plasma protein changes during the postoperative period

Abstract

The patterns of various plasma proteins after operation were studied in control patients and in patients given either Macrodex ® or Rheomacrodex ® for 5 consecutive days. The protein changes were most pronounced from the second to the fourth postoperative day. In the controls, total serum protein, albumin and transferrin decreased by 10–15%. α 1-Antitrypsin and haptoglobin increased by 70–100%, and C 3 and C 4 by 25%. α 2-Macroglobulin, IgA, IgG and IgM remained unchanged. Following infusions of Macrodex ®, total serum protein, albumin and transferrin fell by 30–40%. α 1-Antitrypsin increased as in the controls, whereas haptoglobin, C 3 and C 4 decreased by 10–25%. α 2-Macroglobulin, IgA and IgM decreased by about 25%, and IgG by almost 40%. Rheomacrodex ® did not modify the patterns of total serum protein, albumin, transferrin, α 1-antitrypsin, α 2-macroglobulin and IgM. Haptoglobin, C 3, C 4, IgA and IgG changed in a similar way as that occurring with Macrodex ®, but to a less pronounced extent. Complex formation and/or increased consumption was probably the main cause of the adjustment to lower levels of α 2-macroglobulin, haptoglobin, fibrinogen, C 3, C 4 and the immunoglobulins during dextran treatment in the postoperative period. The more pronounced changes after infusion of Macrodex ® were partly caused by blood volume expansion, as judged by hematocrit. When Macrodex ® was infused in the absence of a surgical trauma, no evidence of protein consumption was found. Although no untoward clinical reactions occurred, some of the dextran-induced, postoperative changes in the level of the plasma proteins may be undesirable.