The hemostatic effect of recombinant (r)-aprotinin was studied in 41 patients undergoing cardiopulmonary bypass surgery. Flow cytometry was used to measure the expression of glycoprotein lb (GPlb) and α-granule membrane protein 140 (GMP-140) on platelets. Additional parameters studied were β-thromboglobulin (β-TG), fibrinogen, fibrinopeptide A, plas-minogen, platelet count, and the amount of postoperative chest tube drainage. Chest tube drainage was significantly less in the r-aprotinin-treated patients (p < 0.001). The percentage of platelets expressing GMP-140 increased to 9.7% in r-aprotinin patients and to 12.1 % in controls during the surgery. The difference between both groups was not significant. Both values returned to baseline the next day. GPlb expression decreased in both groups by 33-38% during the surgery and returned to baseline the next day. GPlb expression and the plasma concentrations of fibrinogen, fibrinopeptide A, β-TG, and plasminogen were not different in r-aprotinin and control patients. We conclude that r-aprotinin reduces blood loss during cardiopulmonary bypass surgery, but the primary mechanism is likely not through a protective effect on platelets.

Keywords:
Aprotinin, Cardiopulmonary bypass surgery, Platelet function, Granule membrane protein 140, Glycoprotein lb, Flow cytometry
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© 1993 S. Karger AG, Basel
1993
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