Sequential changes of alpha1-antitrypsin after surgical trauma.

alpha1-Antitrypsin, an acute phase reactant, is known to rise following surgery [1,2]. It has not been previously reported, however, that the rise is preceded by an initial drop. Our study on a large group of surgical patients confirms the rise, but also shows that a significant drop in alpha1-antitrypsin levels occurs prior to the increase, if the serum samples are obtained immediately after completion of surgery. The observed decrease was independent of age, sex, type of surgery performed or the anesthetic administered. It is postulated that the decrease in serum levels is the result of migration of alpha1-antitrypsin to the tissues injured during surgery.