Decreasing use of donated blood and reduction of bleeding after orthotopic heart transplantation by use of aprotinin

Abstract

Twenty patients undergoing orthotopic heart transplantation were randomized preoperatively to receive either the serine proteinase inhibitor aprotinin in a low dose (560 mg; n = 10) or a placebo (control group, n = 10) at the time of transplantation. Blood loss 24 and 48 hours after transplantation was significantly lower in the group treated with aprotinin (i.e., 510 ml vs 820 ml, p less than 0.01, and 690 ml vs 1000 ml, p less than 0.03, respectively. Accordingly, the aprotinin group required significantly less transfused blood in the first 48 postoperative hours 0 to 250 ml versus 0 to 1000 ml (p less than 0.04). Seventy percent of the patients treated with aprotinin underwent transplantation without the need of nonautologous blood, compared with only 30% in the control group.