Aprotinin, or bovine pancreatic trypsin inhibitor, BPTI (brand name Trasylol, manufactured by Bayer) is a protein used as medication administered by injection to reduce bleeding during complex surgery, such as heart and liver surgery. Primarily, it slows the process of fibrinolysis, which leads to the breakdown of blood clots. The aim in its use was to decrease the need for blood transfusions during surgery, as well as end-organ damage due to hypotension (low blood pressure) as a result of marked blood loss.

Trasylol was set to be the next high point for pharmaceutical behemoth Bayer; the company even ignored warnings from researchers as early as the 1980s stating the drug could potentially have deadly side-effects. Those side effects include renal (kidney) failure, heart attack, stroke, thrombosis (blood clot), and death.

The drug was temporarily withdrawn worldwide in 2007 after studies suggested that its use increased the risk of complications or death; after confirmation from follow-up studies, Trasylol was entirely and permanently withdrawn in May 2008, except for restricted research use. Delays in action by both the FDA as well as Bayer may have resulted in the deaths of thousands of patients each month.

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