COAGULATION TESTS, BLOOD-LOSS, AND TRANSFUSION REQUIREMENTS IN PLATELET-RICH PLASMAPHERESED VERSUS NONPHERESED CARDIAC-SURGERY PATIENTS

The results of several studies suggest that acute platelet-rich plasma pheresis decreases blood loss and allogeneic blood product transfusion requirements in cardiac surgery patients. We designed a randomized, p rospective study to determine whether acute platelet-rich plasmapheres is decreases blood loss and allogeneic transfusion requirements in pri mary cardiac surgery patients. Forty patients were randomized to a con trol or pheresis group. The pheresis group had platelet-rich plasmaphe resis performed before cardiopulmonary bypass (CPB) and the platelet-r ich plasma (PRP) was returned after CPB. The control group was managed in the normal fashion without pheresis. All patients had serial coagu lation studies, hemoglobin, and platelet counts determined intra- and postoperatively. Chest tube drainage and transfusion requirements were recorded. There were no differences in the coagulation tests, platele t counts, chest tube drainage, or allogeneic blood product transfusion requirements between the two groups at any time. The authors conclude that the use of acute platelet-rich plasmapheresis in primary cardiac surgery patients does not decrease chest tube drainage or the need fo r allogeneic blood transfusions.