American Society of Hirudotherapy

Anaphylactoid reactions associated with contaminated heparin from China

Review published in Annales pharmaceutiques francaises (2011)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsSafety & Infection ControlMontpas N et al. · Annales pharmaceutiques francaises, 2011

Abstract

In January 2008, fatal anaphylactoid reaction (AR) was found to be associated with oversulfated chondroitin sulphate (OSCS) contaminated heparin. Although attributed to bradykinin released during contact system activation by OSCS, no final evidence until now exists for a bradykinin release during incubation of contaminated heparin with human plasma. The first objective of our study was to measure and to characterize the kinetic profile of bradykinin release in human plasma incubated with OSCS and contaminated heparin. As these AR occurred mainly in the first minutes of the dialysis session, we examine the different factors likely to influence the kinin-forming capacity of OSCS: dilution of plasma, presence of an angiotensin converting enzyme inhibitor, capacity of the patient to metabolise kinins.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeEnglish AbstractJournal ArticleReview
Indexed MeSH termsAminopeptidasesAnaphylaxisAngiotensin-Converting Enzyme InhibitorsAnticoagulantsBradykininChinaChondroitin SulfatesDialysisDrug ContaminationHeparinHumansKinins

Summary

In January 2008, fatal anaphylactoid reaction (AR) was found to be associated with oversulfated chondroitin sulphate (OSCS) contaminated heparin.

Why This Matters for Hirudotherapy

This article examines the 2008 crisis of fatal anaphylactoid reactions associated with oversulfated chondroitin sulfate (OSCS)-contaminated heparin, focusing on characterizing the kinetic profile of bradykinin release in human plasma incubated with OSCS and contaminated heparin. It also explores factors likely to influence the kinin-forming capacity of OSCS, such as plasma dilution, angiotensin-converting enzyme inhibitors, and patient kinin metabolism. The study provides mechanistic insight into how contaminants in biological anticoagulant products can trigger severe adverse reactions. However, this work has no direct involvement with leeches or the leech secretome; its relevance to hirudotherapy is purely conceptual and indirect, limited to general safety considerations around biological therapeutics.

Citation

Anaphylactoid reactions associated with contaminated heparin from China

Montpas N et al. · Annales pharmaceutiques francaises, 2011

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.