BACKGROUND: @entity16594 , a @entity563 proteinase inhibitor, reduces @entity548 during cardiac surgery. As @entity16594 is derived from @entity291 lung, it has antigenic properties. This investigation examined the incidence of anaphylactic reactions in @entity1 reexposed to @entity16594 and the relation to preformed antiaprotinin immunoglobulin (Ig)G and IgE antibodies. METHODS: This prospective observational study conducted at five centers in Germany evaluated @entity1 undergoing repeat cardiac surgery reexposed to @entity16594 between 1995 and 1996. Antiaprotinin IgG and IgE antibody measurements, using a noncommercial enzyme-linked immunosorbent assay and an immunofluorescence assay, respectively, were performed preoperatively and postoperatively. An anaphylactic reaction was defined as major changes from baseline within 10 min of @entity16594 administration of systolic pressure 20% or greater, heart rate 20% or greater, inspiratory pressure greater than 5 cm @entity2507 , or a skin reaction. RESULTS: In 121 cases (71 adults, 46 @entity1 ), a mean @entity16594 reexposure interval of 1,654 days (range, 16-7,136 days) was observed. Preoperative antiaprotinin IgG (optical density ratio > 3) and IgE antibodies (radioallergosorbent test [RAST] score < 3) were detected in 18 and 9 @entity1 , respectively. High concentrations of each (IgG, optical density ratio > 10; IgE, RAST score > or = 3) were detected in five @entity1 . Three @entity1 (2.5%; 95% confidence interval, 0.51-7.1%) experienced an anaphylactic reaction after @entity16594 exposure, followed by full recovery; these @entity1 had reexposure intervals less than 6 months (22, 25, and 25 days) and the highest preoperative IgG concentrations of all @entity1 (P < 0.05). Assay sensitivity was 100%, as no anaphylactic reactions occurred in IgG-negative @entity1 (95% confidence interval, 0.0-3.1%); assay specificity was 98%. Preoperative IgE measurements were quantifiable in two of three reactive @entity1 and in three nonreacting @entity1 . CONCLUSIONS: Quantitative detection of antiaprotinin IgE and IgG lacks specificity for predictive purposes; however, quantitation of antiaprotinin IgG may identify @entity1 at risk for developing an anaphylactic reaction to @entity16594 reexposure.

Anaphylactic reactions to XXXX reexposure in cardiac surgery: relation to antiaprotinin immunoglobulin G and E antibodies.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity16594 :: ('404172(Tax:9913)', 'Gene') :: ['Aprotinin', 'aprotinin'] @entity2507 :: ('CHEBI:33813', 'Chemical') :: ['H2O'] @entity563 :: ('CHEBI:17822', 'Chemical') :: ['serine'] @entity291 :: ('9913', 'Species') :: ['bovine']
@entity16594 :: (404172(Tax:9913),Gene) :: ['aprotinin']
