Hello Rusty,
It is a great thought. Off the cuff, I can't speak to how commonly ATIII dosing is required for CABG patients in the situation described. I'll be happy to talk with cardiac surgery friends to get an idea.
If ATIII were given commonly during CABG, it would certainly make for a large, stable market -- that in the near future when ATIII is FDA approved, could be easily used off-label. With a relatively brisk follow on indication further supporting this use, a partner could make significant amounts of money.
As to the plasma vs recombinant product question, certainly in the U.S. (and I think increasingly around the world), the safety profile of recombinant product is just too much superior to allow continued use of pooled product. As we've seen in the news over the last months, even in the modestly well-controlled porcine heparin product supply line, the risk of introducing unintended contaminants is both real and large. I think of it as the difference between sweeping the street and then trying to carefully pick up the pieces you want to be clean vs. manufacturing them in a carefully controlled environment. One is inevitably far safer than the other.
With all 'dew' deference, unless the cost is simply ridiculous, or the hurdles to obtaining it overwhelming (which better not be the case, LEO!) even the Europeans will accept this logic and start regularly using recombinant product to the exclusion of pooled serum.
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