Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Cardiovascular Anesthesia
Most commercially available fibrin adhesives contain aprotinin in doses of 3,000 KIU/ml. They are used in many surgical disciplines . There is an elevated risk of hypersensitivity reactions at systemic reexposure to aprotinin . Our aim was to examine the immunogenic potency of the substance as a content of fibrin adhesive.
METHODS: We investigated 49 children with congenital heart disease treated surgically. All patients received aprotinin only topically as contained in commercially available fibrin glue. Serum samples were drawn preoperatively, 1 week, 2 weeks, 6 weeks and approximately 1 year after surgery. They were analyzed for aprotinin-specific IgG antibodies employing a standard ELISA and a fluorescence enzyme immunoassay for aprotinin-specific IgE antibodies.
RESULTS: (Table 1)
The doses of aprotinin given did not differ significantly in antibody-negative and -positive patients, the median age of IgG-negative children was significantly lower (7.8 vs. 25.8 months, p < 0.05).
CONCLUSION: Our findings show the existence of a sub-group of patients developing aprotinin-specific IgG and IgE antibodies after topical application of aprotinin. If aprotinin use in any form is planned in a patient having received aprotinin as contained in commercially available fibrin adhesives, we propose prophylactic measures as monitoring, an intravenous line and pretreatment with antihistaminics to avoid unexpected anaphylactic reactions.
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