Hemostasis may be systemically enhanced with pharmacologic agents. Antifibrinolytics,
such as aprotinin and lysine analogues (ε-aminocaproic acid and tranexamic acid), act by
inhibiting fibrinolysis and maintaining clot formation at the sites of bleeding. These agents
are therefore effective only if fibrinolysis is contributing to the bleeding. While aprotinin has
been found to be more effective in reducing transfusion requirements in cardiac surgery,
mounting concerns about the safety of aprotinin (possible risk of renal failure and myocardial
infarction) have resulted in the suspension of its marketing until further safety information is
available