Mannose-binding lectin (MBL) and post-operative complications/bypass patency with arterial operations

In literature (see reference) the following things arise:
o Associations between MBL-deficiency and increased chance for infectious
diseases are reported, also in healthy patients.
o Also stronger in patients with co-morbidities such as immunological disorders
or chronic illness.
o These patients of MBL-deficiency have an increased chance for post-operative
wondinfections and surgical complications.
o Patients undergoing a livertransplant, where the liver has the favorablde
genotype, direct after surgery they show increased values in serum.
o This is also the other way around, so if the patient first has high
expression, but the liver low expression. Direct after surgery the quantity in
serum drops. This both is subject to to the fact that production takes places
in the liver.
o The MBL-pathway provides activation of the classical pathway of the immune
system respons, so if some patient is immune compromised en there is a lower
expression of the MBL-pathway these patients have increased risk for
complications
o Mutation in the MBL-gene have a significante negative impact on chronic
illness, like reumatoid arthritis, SLE and cystic fibrosis, which results in
increased incidence of complicated infections an worse outcome.
o The protective rol of MBL against infections can be explained by the direct
binding of MBL to Micro-organisms.
o The concentration of MBL is many times higher in new onset diabetic in
comparison with similar study patients.
o MBL is associated with vascular complications in diabetics, certain genotypes
are significant more vulnerable to nefropathy
o In short, MBL can be associated with the pathogenesis of microvasculair
complications.

Demonstrate the possible difference in complications and bypass patency in
certain large arterial operations with regard to the expression of the
MBL-genotype.
• Femoral/Crural

patients undergoing a great arterial operation (Femoral/Crural). In front we
will obtain informed consent and pre-operative we will obtain one bloodsample
of heparenized blood for determining of the genotype. This determination will
be done in de laboratorium.
All patients will be classified to risk factors, such as Diabetic mellilitis,
smoking, cardi-vasculair diseases. Results from the research will be treated
anonymous and confidential.

Considering that every patient pre-operative will get a infuse, there will not
be any additional risk, while through this venous input on-off a heparinized
serum sample for determining the MBL-genotype. In short there will not be any
extra invasive action be carried out.