APROTININ THERAPY FOR INSERTION OF VENTRICULAR ASSIST DEVICES FOR STAGED HEART-TRANSPLANTATION

Bleeding after insertion of ventricular assist devices is a common pro blem which carries a major risk of immediate and late complications. W e evaluated the safety and efficacy of aprotinin in six patients under going staged heart transplantation and compared the results with those of six patients who received no aprotinin. The groups did not differ significantly with respect to age, gender, preoperative cause of cardi omyopathy, or cardiopulmonary bypass time. Patients treated with aprot inin had a significant reduction in postoperative chest tube drainage (743 +/- 457 versus 2036 +/- 1184 cc, respectively, for aprotinin ther apy versus no therapy; p = 0.047). Blood transfusion requirements were reduced in patients treated with aprotinin (2.2 +/- 2.2 versus 10.7 /- 7.1 U respectively, for aprotinin therapy versus no therapy; p = 0. 038). No demonstrable serious side effects were attributed to the apro tinin treatment. We conclude that aprotinin is effective in reducing b leeding and transfusion requirements without increasing the incidence of clinically significant renal dysfunction or thromboembolic events.