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Intraoperative anaphylaxis to gelatin-based hemostatic agents: a case report
Gülen Arslan Lied1,2,3, Kjetil Børve Lund4, Torgeir Storaas2
1Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Journal of Asthma and Allergy
|July 30, 2019
Summary
A patient experienced severe allergic reactions during surgery due to a gelatin hemostatic agent. This highlights the risk of anaphylaxis from porcine gelatin in patients with alpha-gal syndrome or red meat allergy.
Area of Science:
- Anesthesiology
- Allergology
- Surgical Innovation
Background:
- Absorbable gelatin matrix hemostatic agents, like Surgiflo, are common in surgery.
- These products contain porcine gelatin, posing a risk for allergic reactions.
- Intraoperative anaphylaxis is a rare but serious complication.
Purpose of the Study:
- To report a case of intraoperative anaphylaxis to a gelatin hemostatic agent.
- To investigate the underlying allergic mechanism.
- To emphasize precautions for patients with specific allergies.
Main Methods:
- Case report of a 71-year-old male patient.
- Allergological examination including specific IgE testing.
- Analysis of intraoperative events and patient history.
Main Results:
- The patient developed anaphylaxis with cardiovascular events during surgery.
- Anaphylaxis was linked to the use of Surgiflo (porcine gelatin).
- The patient had a history of red meat allergy, tick bites, and high alpha-gal IgE levels.
Conclusions:
- Patients with red meat allergy, tick bite history, or alpha-gal syndrome are at risk for anaphylaxis to porcine or bovine gelatin.
- Preoperative screening for alpha-gal allergy is crucial before using gelatin-based hemostatic agents.
- Careful consideration of patient history and allergies is essential to prevent adverse events during surgery.
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