The role of AAT-1 in mitigating inflammatory response has been established. CPB is a potent stimulator of inflammatory cascades and associated with bleeding diatheses, coagulation abnormalities, potentially leading to organ dysfunction. To date, the administration of AAT-1 in patients undergoing cardiac surgery with CPB has not been explored. It may be postulated that inherent AAT-1 effects may offset deleterious CPB effects. This may clinically result in improved preservation of organ function, reduced postoperative bleeding and reduced hospital stay. The benefits of other protease inhibitors in corresponding settings have been recently demonstrated (41-43).