APROTININ IMPROVES HEMOSTASIS AFTER CARDIOPULMONARY BYPASS BETTER THAN SINGLE-DONOR PLATELET CONCENTRATE

Platelet transfusion and aprotinin administration improve platelet fun ction and clinical hemostasis after extracorporeal circulation. To com pare two methods of improving postoperative hemostasis, we preoperativ ely randomized 40 patients undergoing various open heart procedures in to two groups. Group A included 20 patients who, immediately after byp ass, received single-donor plateletpheresis concentrates collected fro m ABO-compatible donors (Baxter Autopheresis-C System). They were comp ared with 20 patients who received high-dose aprotinin (6 x 10(6) KIU) before and during cardiopulmonary bypass (group B). Group A patients showed significantly higher platelet count after single-donor platelet pheresis concentrate transfusion (157 +/- 36 x 10(9)/L compared with 1 18 +/- 42 x 10(9)/L (p < 0.05). However, platelet aggregation on extra cellular matrix was better in group B (3.4 +/- 0.7 versus 2.8 +/- 0.9; p < 0.05). Total 24-hour blood loss and exposure to homologous blood products were significantly less in group B (396 +/- 125 mt and 1.1 +/ - 1.6 units compared with 617 +/- 233 mL and 5.4 a 3.4 units; p < 0.01 ). Despite higher platelet count in patients after single-donor platel etpheresis concentrates transfusion, hemostasis in patients receiving aprotinin is better due to improved platelet function.