Aprotinin Has no Effect on Platelet Activation and Adhesion during Cardiopulmonary Bypass

Alexander Wahba; Gregor Black; Mario Koksch; Gregor Rothe; Jürgen Preuner; Gred Schmitz; Dietrich E Bimbaum

doi:10.1055/s-0038-1650377

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1996; 75(05): 844-848
DOI: 10.1055/s-0038-1650377

Original Article

Schattauer GmbH Stuttgart

Aprotinin Has no Effect on Platelet Activation and Adhesion during Cardiopulmonary Bypass

Alexander Wahba

¹The Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany

,

Gregor Black

¹The Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany

,

Mario Koksch

²The Department of Clinical Chemistry of the Klinikum Regensburg, University of Regensburg, Germany

,

Gregor Rothe

²The Department of Clinical Chemistry of the Klinikum Regensburg, University of Regensburg, Germany

,

Jürgen Preuner

¹The Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany

,

Gred Schmitz

²The Department of Clinical Chemistry of the Klinikum Regensburg, University of Regensburg, Germany

,

Dietrich E Bimbaum

¹The Department of Cardiac, Thoracic, and Vascular Surgery, University of Regensburg, Germany

› Author Affiliations

Abstract

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Summary

Aprotinin reduces blood loss following cardiopulmonary bypass operations (CPB) by the prevention of hyperfibrinolysis. Its influence on circulating platelets is uncertain. In this prospective trial we investigated activation, adhesion, and aggregation receptors on the platelet surface in 20 patients who underwent elective coronary artery bypass grafting. These patients were randomly assigned to receive either a high dose of aprotinin or placebo. Flow cytometry was performed to determine platelet activation [P-selectin, glycoprotein (GP) 53], adhesive (GP Ib), and aggregatory (GP IIb-IIIa) receptors on circulating platelets, before, during, and after CPB. Aprotinin had neither a significant effect on platelet activation nor on adhesive and aggregatory receptors. Plasma levels of D-dimers were measured before and after CPB to assess fibrinolytic activity. D-dimers following CPB and chest tube drainage were significantly less in the aprotinin group. We conclude that aprotinin reduces blood loss by its effect on fibrinolysis but has no direct influence on platelet function.

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References

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