Intraoperative Anaphylaxis in Response to Hemostatic Agents With Protein Derivatives

Area of Science:

• Immunology
• Allergy and Clinical Immunology
• Surgical Innovation

Background:

• Topical hemostatic agents are widely utilized in surgery to control bleeding.
• Many hemostatic agents are derived from human or animal products, posing risks of adverse reactions.
• Alpha-gal syndrome is an IgE-mediated hypersensitivity to mammalian oligosaccharides, often linked to tick bites.

Observation:

• A 44-year-old male patient with alpha-gal syndrome expressed concerns regarding potential allergic reactions to surgical products.
• The patient was scheduled for an open reduction and internal fixation of a left distal radius fracture.
• The patient's history includes a tick bite and subsequent allergy to mammalian proteins, including red meat.

Findings:

• This case report underscores the potential for immunogenic reactions to mammalian-derived components in topical hemostatic agents.
• Physicians need increased awareness of alpha-gal syndrome and its implications in surgical settings.
• The widespread use of mammalian products in hemostatic agents necessitates careful patient screening and product consideration.

Implications:

• Promoting physician awareness of alpha-gal syndrome can mitigate risks associated with hemostatic agents.
• Encouraging medical device companies to disclose mammalian product components is crucial for patient safety.
• Development of alternative, non-mammalian hemostatic agents is needed to address patient allergies and improve surgical outcomes.