Abstract

High postoperative mortality in patients undergoing aortic abdominal aneurysm (AAA) repair is predominantly associated with ischemia and reperfusion organ injury followed by multiple organ dysfunction syndrome (MODS). Experimental studies have shown a role of growth-related oncogene a (GROa) chemokine in mediating organ damage during ischemia-reperfusion injury. The study evaluated serum GROalpha levels during elective AAA repair in humans and the relationship between their changes and ischemia-reperfusion and the postoperative course. Peripheral blood samples were taken from 17 patients before surgery (Preop), before aorta unclamping, 90 minutes after unclamping (90 min-Xoff) and 24 hours after surgery, and from 11 controls. The GROalpha was measured with an enzyme-linked immunosorbent assay. During AAA repair the GROalpha level showed an insignificant decrease from 79 pg/ml at Preop to 61 pg/ml at 90 min-Xoff followed by an increase to 100 pg/ml 24 hours after surgery. In complicated cases the GROalpha level showed a tendency to intraoperative higher values and increased to 133 pg/ml 24 h after surgery. Significant positive correlations were found between GROalpha and duration of surgery (r = 0.317), duration of aorta clamping (r = 0.322) and MOD score (r = 0.417). AAA repair is associated with insignificant alterations in the serum GROalpha level. A decrease in chemokine levels after ischemia and reperfusion may suggest uncomplicated postoperative courses. The tendency to high chemokine levels may be associated with high risk of postoperative organ dysfunction in patients undergoing AAA repair.

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