impact of autologous platelet rich plasma transfusion on clinical outcomes in descending thoracic...
TRANSCRIPT
Impact of Autologous Platelet Rich Plasma Transfusion On Clinical
Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair
Cardiothoracic and Vascular AnesthesiaDepartment of Anesthesiology
The University of Texas Medical School at Houston
S. Zhou, MD, A. Estrera, MD, T. LI, MD, C. Ignacio, MD, S. Panthayi, MD, H. Safi, MD, R.
Sheinbaum, MD
Autologous Platelet Rich Plasma
HarvestingHarvestingPlatelet Rich PlasmaPlatelet Rich Plasma
WB
aPRPRBC
Collected by harvesting 15-20 ml/kg whole blood prior to CPB Fractionating off the PRP component.
The goal was a yield of 10-15 ml/kg of aPRP.
aPRP was used to reestablish hemostasis and significantly reduce intra-operative transfusions
Investigate the effect of aPRP transfusion on the clinical outcome of patients undergoing TAAA repair.
Purpose
Retrospectively reviewed 535 cases of TAAA repair
Ages 18-80,
From Feb. 2003 to July 2008.
182 patients received aPRP harvest and 353 patients did not.
Materials and Methods
Patient Demographics
Demographics and surgical characteristic between two groups were similar.
Intra-Operative Blood Transfusion
Intra-Operative blood transfusions were significantly reduced in the aPRP cohort .
Intra-Operative Blood Transfusion
Results In the PRP group
24/182 (13.2%) received no transfusions
134/182(73.6%) received no platelet transfusion
69/182(37.9%) required 4 or less units of PRBC transfusion
Morbidity
Time To Extubation
The aPRP group also required reduced ventilator time and were extubated earlier
Conclusions
Use of PRP in thoracic and thoracoabdominal aortic aneurysm repair resulted in reduced blood product utilization translating into improved morbidity and mortality.
Prospective randomized studies are required.