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Ann Thorac Surg 1998;65:S60-S64
© 1998 The Society of Thoracic Surgeons

Incidence of Hypersensitivity Reactions

^a German Heart Center, Munich, Germany

Address reprint requests to Dr Dietrich, German Heart Center, Lazarettstr 36, 80636 Munich, Germany

Presented at Risk Assessment of Major Perioperative Issues in Pediatric Cardiac Surgery, Washington, DC, May 7, 1997.

Background. Aprotinin is a naturally occurring serine protease inhibitor derived from bovine lung. In common with all foreign proteins, it possesses antigenic properties and has the possibility of allergic reactions on reexposure.

Methods. Data are presented on the incidence of adverse reactions to aprotinin and the time course of antibody development after initial exposure. Recommendations for reducing the risk and sequelae of these adverse reactions are emphasized and case reports are reviewed.

Results. The incidence rates of aprotinin-related reactions to date (May 1997) at the German Heart Center are 2.7% in the adult population in reexposures (5/183) and 1.2% in the pediatric population (3/254), with an overall incidence of 1.8% (8/437).

Conclusions. With the recommended precautions, reexposure to aprotinin in patients with a high risk of bleeding is justified, and the benefits of aprotinin treatment outweigh the relative risk of a serious allergic reaction.

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