ABSTRACT Background: Aprotinin has been used increasingly to reduce postoperative blood loss in open-heart operations due to the potentialities for complications and high cost, it would seem reasonable to use aprotinin more selectively in small doses in the prime solution of the pump. Methods: We prospectively studied the effect of preoperative low dose aprotinin [2 million units (230mg)] on b...

abstract background: aprotinin has been used increasingly to reduce postoperative blood loss in open-heart operations due to the potentialities for complications and high cost, it would seem reasonable to use aprotinin more selectively in small doses in the prime solution of the pump. methods: we prospectively studied the effect of preoperative low dose aprotinin [2 million units (230mg)] on bl...

Fibrin has been long used clinically for hemostasis and sealing, yet extension of use in other applications has been limited due to its relatively rapid resorption in vivo, even with addition of aprotinin or other protease inhibitors. We report an engineered aprotinin variant that can be immobilized within fibrin and thus provide extended longevity. When recombinantly fused to a transglutaminas...

Following preincubation of aprotinin with gelatin, the inhibitory effect on the trypsin activity was enhanced under the same condition as in the case of enhanced antigen-antibody reaction of aprotinin in gel in the presence of gelatin. In the immunochemical titration of aprotinin, gelatin treatment decreased the value of the equivalence point of aprotinin. Immunoprecipitation of aprotinin prein...

OBJECTIVE To test the hypothesis that use of aprotinin at hall dose would be more cost-effective or as efficacious as full-dose aprotinin or no aprotinin during open heart surgery. DESIGN Cost-effective analysis, unmasked prospective comparison. SETTING Community hospital. PATIENTS One hundred thirty-three patients undergoing open heart surgery. INTERVENTIONS Patients in 3 consecutive g...

Aprotinin has been used widely in surgery as an anti-bleeding agent but is associated with a number of side effects. We report that textilinin-1, a serine protease inhibitor from Pseudonaja textilis venom with sequence relatedness to aprotinin, is a potent but reversible plasmin inhibitor and has a narrower range of protease inhibition compared to aprotinin. Like aprotinin, textilinin-1 at 5 mi...

Dextran sulfate has an action on aprotinin activity similar to that seen with heparin: preincubation of dextran sulfate with aprotinin enhanced the inhibitory effect of aprotinin on the esterolytic activity of trypsin, but did not change the effect on the proteolytic activity of trypsin or on the esterolytic and proteolytic activities of chymotrypsin. The enhancing effects of heparin and dextra...

To the Editor:—Two classes of intravenous drugs are commonly used in the perioperative setting to mitigate bleeding after cardiac surgery: lysine analogs (e.g., aminocaproic acid, tranexamic acid) and serine protease inhibitors (e.g., aprotinin). In contrast to the lysine analogs, intravenous aprotinin administration has been shown in several nonrandomized studies to be associated with worsened...

OBJECTIVE Aprotinin is a widely used serine protease inhibitor during cardiopulmonary bypass to reduce blood loss and preserve platelet function. However, the bovine-derived aprotinin can induce hypersensitivity reaction with fatal complications. Furthermore, vascular effects of aprotinin are not completely elucidated. The current study is designed to investigate the effects of recently develop...

OBJECTIVE Aprotinin has been widely used to reduce bleeding and transfusion requirements in cardiac surgery and in lung transplantation. A recent study found a significant reduction in severe (grade III) primary graft dysfunction (PGD) in lung transplantation where aprotinin had been used. However, recently, concerns regarding the safety of aprotinin have been raised, and the future use of apro...