Summary
Twenty-one cardiothoracic surgical patients have been treated with fibrin as a topical
hemostatic/sealing agent, prepared from bovine fibrinogen clotted with bovine thrombin.
Serum samples have been collected before treatment with fibrin and postoperatively
between 1 and 9 days, 3 and 12 weeks, and 6 and 8 months. The titers of anti-bovine
fibrinogen antibodies, measured by ELISA specific for immunoglobulins IgG or IgM,
increased to maximal values after about 8 or 6 weeks, respectively. After 8 months,
IgG titers were on average 20-fold lower than the mean maximal value, while IgM titers
returned to the normal range. IgG was the predominant anti-bovine fibrinogen immunoglobulin
as documented by ELISA, affinity chromatography and electrophoresis. Anti-bovine fibrinogen
antibodies present in patients reacted readily with bovine fibrinogen, but did not
cross-react with human fibrinogen as measured by ELISA or by immunoelectrophoresis.
A significant amount of antibodies against bovine thrombin and factor V has been found,
many cross-reacting with the human counterparts. No hemorrhagic or thrombotic complications,
or clinically significant allergic reactions, occurred in any patient, in spite of
antibody presence against some bovine and human coagulation factors. The treatment
of patients with bovine fibrin, without induction of immunologic response against
human fibrinogen, appeared to be an effective topical hemostatic/sealing measure.
