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CARDIOVASCULAR ANESTHESIOLOGY

Anaphylactic Reaction After Systemic Application of Aprotinin Triggered by Aprotinin-Containing Fibrin Sealant

Benjamin J. Kober^*, Albertus M. Scheule, MD^*, Vladimir Voth, MD^*, Norbert Deschner, MD, Eckhard Schmid, MD, and Gerhard Ziemer, MD^*

From the *Department of Thoracic, Cardiac and Vascular Surgery; and Department of Anesthesiology and Intensive Care, Tübingen University Hospital, Tübingen, Germany.

Address correspondence and reprint requests to Prof. Dr. med. Albertus M. Scheule, Division of Thoracic, Cardiac and Vascular Surgery, Tübingen University Hospital, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. Address e-mail to albertus.scheule{at}med.uni-tuebingen.de.

Abstract

We report a 67-yr-old male after multiple surgical procedures for treatment of arterial occlusive disease who suffered an anaphylactic reaction after administration of aprotinin (Trasylol®) prior to urgent coronary artery bypass surgery. The patient had been treated with aprotinin-containing fibrin sealant in 2004 and in 2007, 2 wk before coronary artery bypass surgery. The postoperative serologic screening revealed positive results for qualitative aprotinin-specific IgG, highly elevated quantitative aprotinin-specific IgG and moderately elevated aprotinin-specific IgE antibodies.