Risk of anaphylaxis from aprotinin re-exposure during LVAD removal and heart transplantation.
Aprotinin has been shown to reduce transfusion requirements in re-operative cardiac surgery and in implantation of long-term left ventricular assist devices (LVAD). However, it is an antigenic polypeptide and re-exposure is associated with a small incidence of anaphylaxis. This report describes 2 cases of anaphylactic response to aprotinin when the agent was employed for both the LVAD implant and for the subsequent explant and cardiac transplant. Early re-exposure to just the test dose was associated with a significant incidence of anaphylaxis.
Milano
Carmelo A
CA
Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA. milan002@mc.duke.edu
Patel
Vijay S
VS
Smith
Peter K
PK
Smith
Mark Stafford
MS
D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D007611:Aprotinin / Q000009:adverse effects*; D020878:Device Removal; D005260:Female; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery; D015842:Serine Proteinase Inhibitors / Q000009:adverse effects*
D015842:Serine Proteinase Inhibitors; D007611:Aprotinin