| Reference |
Total number of patients |
Prospective study |
Dose |
Results |
| Aprotinin |
|
|
|
|
| Neuhaus et al.1989(20) |
20 |
No |
2 million KIU |
Reduction in RBC,FFP and surgical time |
| Mallett et al. 1990(19) |
24 |
No |
2 million KIU followed by 500.000 KIU/hour during surgery: 70.000 KIU each RBC |
|
| Cottam et al.1991(21) |
8 |
No |
2 million KIU and followed by 500.000 KIU/hour, 50.000 KIU given to each unit of RBC |
Reduce t-PA production and increase alpha-2 antiplasmin |
| Grosse et al.1991(22) |
50 |
No |
2 million KIU followed by 500.000 during surgery |
Reduce fibrinolysis(measured by TEG),RBC,FFP, and platelets |
| Himmelreich et al.1992(23) |
23 |
No |
500.000 KIU bolus before, during and after reperfusion |
Smaller increase in t-PA in comparison to other studies |
| Soilleux et al., 1995(24) |
189 |
Yes |
2 million KIU load plus 500.000 KIU/hour infusion or 500.000 KIU load plus 150.000 |
No differences in RBC in the high and low dose aprotinin group |
| Scudamore et al., 1995(25) |
66 |
No |
1 million KIU bolus plus 500.000 KIU/hour infusion |
Reduction in Cryo,FFP, RBC in the aprotinin but not in the EACA group |
| Milroy et al.,1995(26) |
52 |
Yes |
Load 280 mg pus 70 mg/hour infusion,additional 140 mg to bypass |
Greater SVRI,O2 extraction ratio and less CI,DO2 5 minutes after reperfusion |
| Marcel et al.,1996(27) |
44 |
Yes |
200.000 KIU/hour infusion |
Reduce FFP,Cryo but not RBC or platelets,less EACA rescue |
| Garcia-(28)Huete,1997 |
80 |
Yes |
2 million KIU plus 500.000/hour |
No difference in EBL, blood products |
| Porte et al.,2000(29) |
137 |
Yes |
High: 2 million KIU load plus 1 million/hour plus 1 million 30 min before reperfusion,low: 2 million plus 500.000/hour |
60% and 44%EBL,37% and 20% RBC reduction in high and regular dose groups, compared to placebo |
| Findlay et al.,2001(70) |
63 |
Yes |
1 million KIU load plus 250.000 KIU/hour |
Reduce RBC requirements but not FFP, platelets or cryo |
| Molenaar et al., 2001 |
93 |
Yes |
High: 2 million load plus 1 million/hour plus 1 million before reperfusion,low:2 million + 500.000 KIU/hour |
No renal toxicity |
| Molenaar et al.,2001 |
137 |
Yes |
High: 2 million load plus 1 million/hour plus 1 million 30 min before reperfusion,low:2 million + 500.000KIU/hour |
Better 1- month graft survival |
| Molenaar et al.,2001 |
67 |
Yes |
High and low regimen comparison |
Less epinephrine use in high or low dose group |
| Rentoul et al.,2003(71) |
24 |
No |
15.000 KIU/kg load plus 5000/hour infusion |
Reduce RBC and FFP requirements |
| Findlay and (72)Kufner,2003 |
63 |
Yes |
1 million KIU load plus 250.000KIU/hour |
Less vasoactive infusion in the aprotinin group |
| Warnaar et al.,2007 |
1043 |
No |
2 million KIU load plus 500.000 KIU/hour |
2 time higher risk of severe renal dysfunction within the first week |
| Tranexamic acid(TA) |
|
|
|
|
| Carlier et al.,1987(49) |
33 |
No |
15 mg/kg for 8 hours |
41%of patients with normal ECLT |
| Boylan et al.,1996(52) |
45 |
Yes |
40 mg/kg/hour uo to 40 g |
Reduced EBL,plasma,platelet and cryo; no RBC |
| Kasper et al.,1997(53) |
32 |
Yes |
2mg/kg/hour |
TA decreased fibrinolysis and need for EACA rescue but not transfusion requirements |
| Epsilon aminocaproic acid (EACA) |
|
|
|
|
| Kaulla1966(57) |
3 |
No |
Not reported |
Patients died of severe hemorrhage or thrombolic complication |
| Kang et al.1987(60) |
20 |
No |
1 gm |
fibrinolysis’s improvement |
| Scudamore et al. 1995 (13) |
No |
No |
Non reported |
No effects on transfusion |
