APROTININ REDUCES BLOOD-LOSS IN LUNG-TRANSPLANT RECIPIENTS

After early experience with perioperative bleeding in sequential singl e-lung transplant recipients, aprotinin was introduced in an attempt t o reduce this complication and the attendant morbidity. Records of seq uential single-lung transplantations (n = 33) performed between Januar y 1989 and November 1991 were reviewed to assess the impact of aprotin in on perioperative blood loss and blood product requirements. Recipie nts were divided according to whether or not they required cardiopulmo nary bypass. In patients requiring cardiopulmonary bypass (n = 15), me an estimated postoperative blood loss was 3,000 +/- 500 mL in those wh o did not receive aprotinin (n = 4) compared with 1,177 +/- 253 mL in those who received aprotinin (n = 11) (p < 0.05). An average of 8.0 +/ - 0.7 units of packed red blood cells were administered to patients no t receiving aprotinin compared with 3.1 +/- 0.7 units to those who rec eived aprotinin (p < 0.05). Requirements for fresh frozen plasma were similar in each group. There were no differences in blood loss or bloo d product replacement in the group not undergoing cardiopulmonary bypa ss (n = 18). Therefore, we conclude that aprotinin decreases postopera tive blood loss and blood product requirements in patients undergoing sequential single-lung transplantation under cardiopulmonary bypass.