When used during on-pump cardiac surgery, the blood-conserving drug aprotinin appears to be safe. However, when used in combination with angiotensin-converting enzyme (ACE) inhibitors during off-pump cardiac surgery, it has been associated with a significant risk of renal dysfunction in the postoperative phase. This is the conclusion of authors Mouton, Finch, Davies, Binks and Zacharowski in an article published in the February 8, 2008 edition of The Lancet.
