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

• Published in: The Annals of Thoracic Surgery Vol. 79; no. 2; pp. 741 - 748
• Main Authors: Beierlein, Wolfram, Scheule, Albertus M., Dietrich, Wulf, Ziemer, Gerhard
• Format: Book Review Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2005; Elsevier Science
• Subjects: Aprotinin - adverse effects; Biological and medical sciences; Cardiac Surgical Procedures - methods; Cardiac Surgical Procedures - statistics & numerical data; Drug Hypersensitivity - classification; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - epidemiology; Drug Hypersensitivity - prevention & control; Drug Utilization - statistics & numerical data; Histamine; Humans; Medical sciences; Serologic Tests; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Survival Rate; 16; Treatment; Respiratory disease; Surgery; Hypersensitivity; Use; Aprotinin; Thorax; Review; Reaction; Bibliographic review
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2004.03.072

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.