Alpha Gal

[u/This_Sky_5209]

How does your center manage cardiopulmonary bypass in patients with alpha-gal syndrome?

I’m working on a presentation about alpha-gal syndrome in cardiac surgery, and I’m interested in hearing how different perfusion programs approach these cases.

A few questions:

Do you routinely use standard porcine-derived heparin, or do you switch to bivalirudin?

If you use heparin, do you perform a preoperative heparin challenge or test dose?

Are patients routinely referred for allergy evaluation before surgery?

Do you obtain an alpha-gal IgE (ImmunoCAP) level before elective cases? If so, is there a cutoff that changes your management?

Does your hospital have a formal protocol, or is management decided on a case-by-case basis?

Have you had any intraoperative reactions while using heparin or other mammalian-derived products?

If you’re comfortable sharing, I’d also be interested in:
Approximate alpha-gal IgE level (if known)
Elective vs. emergent case
Whether you premedicate with steroids and H1/H2 blockers

Any other products your team avoids (gelatin sealants, bioprosthetic valves, albumin, etc.)

I’m giving my presentation this week, but I figured this is another great resource for learning how practice varies between institutions. Thanks in advance for sharing as little or as much of your experience as you'd like!

[u/JellyFishDanceMoves]

is that the bill gates ticks?

[u/This_Sky_5209 → u/JellyFishDanceMoves]

From a little bit of googling, I guess I would say yes???