Left ventricular assist system recipients exposed to bovine thrombin preparations have a higher frequency of antiphospholipid antibodies than nonexposed recipients

After left ventricular assist system (LVAS) placement, recipients often dev elop antiphospholipid antibodies (aPL) that are associated with thrombosis. Fibrin glue containing a bovine thrombin preparation is used routinely in LVAS placement surgery. We investigated whether exposure to the thrombin pr eparation is responsible for stimulating aPL development in LVAS recipients . Pre-LVAS and weekly post-LVAS sera from six fibrin glue-exposed LVAS reci pients and five nonexposed recipients were tested by enzyme-linked immunoso rbent assay for IgG, IgA, and IgM anti-phosphatidylserine (aPS), anticardio lipin (aCL), anti-phosphatidylethanolamine (aPE), and anti-phosphatidylchol ine (aPC). Fibrin glue exposed recipients developed a significantly greater number of aPL than the nonexposed recipients (24 vs. 8; p = 0.0069). In pa rticular, a higher frequency of IgG aCL (6/6 vs. 1/5; p = 0.015) and IgG aP E (4/6 vs. 0/5; p = 0.045) were noted. Exposure to the bovine thrombin comp onent of fibrin glue seems to stimulate aPL development in LVAS recipients.