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Ann Thorac Surg 2005;79:741-748
© 2005 The Society of Thoracic Surgeons

Review

Forty Years of Clinical Aprotinin Use: A Review of 124 Hypersensitivity Reactions

Wolfram Beierlein, MDa,*, Albertus M. Scheule, MD, PhDa, Wulf Dietrich, MD, PhDb, Gerhard Ziemer, MD, PhDa

a Department of Thoracic, Cardiac, and Vascular Surgery, Tübingen University Hospital, Tübingen, Germany
b Department of Anesthesiology, German Heart Center Munich, Munich, Germany

* Address reprint requests to Dr Beierlein, Department of Thoracic, Cardiac and Vascular Surgery, Tübingen University Hospital, Hoppe-Seyler Straße 3, D-72076 Tübingen, Germany
wolfram.beierlein{at}t-online.de

Since its clinical introduction, the anaphylactic potential of aprotinin has been a major concern. World wide, its use is expanding so there is an increased chance that patients have reexposure from various sources. The risk of anaphylaxis is approximately 2.8% in reexposed patients. From 1963 to 2003, 124 cases of aprotinin-induced anaphylaxis were reported in 61 publications. Eleven patients died. The reexposure interval was less than 3 months in 72% (38 of 53 patients). This review looks at the profile of patients at risk so preventive measures may be taken. Past and future exposures have to be taken into account before any aprotinin administration.




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