Cardiothoracic and Vascular Anesthesia Department of Anesthesiology

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.