Premium
Preoperative platelet‐rich plasmapheresis and hemodilution with an autotransfusion device in total hip replacement surgery
Author(s) -
Ekbäck Gustav,
Ryttberg Lars,
Axelsson Kjell,
Christianssen Frank,
Kjellberg Jill,
Carlsson Peder,
Carlsson Olle,
Schött Ulf
Publication year - 2000
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/1098-1101(2000)15:4<256::aid-jca7>3.0.co;2-g
Subject(s) - autotransfusion , medicine , plateletpheresis , surgery , plasmapheresis , apheresis , anesthesia , bleed , platelet , platelet rich plasma , hematocrit , autologous blood , blood transfusion , antibody , immunology
The effectiveness of both preoperative autologous donation (PAD) and intraoperative autotransfusion (IAT) with an autotransfusion device has recently been questioned. Preoperative apheresis, with separation of concentrated platelet rich‐plasma (c‐PRP) and erythrocyte concentrate (ERC), represents an aggressive use of the autotransfusion device. Can such a procedure replace PAD in total hip replacement surgery (THR)? Eighty patients undergoing THR were investigated in a prospective and randomized study. Forty patients underwent PAD, and 2 units of ERC + plasma were retrieved within 4 weeks preoperatively. Another 40 patients underwent an immediately preoperative apheresis with a concomitant hemodilution with 4% albumin, retrieving c‐PRP (30% of the platelet pool) and 2 units of ERC. Both groups used IAT up to 2 hours postoperatively, with 3% dextran‐60 as a plasma substitute according to our standard of care. There were no differences in blood loss, B‐hemoglobin or allogeneic transfusions between the groups: 85% of the patients did not receive allogeneic blood. Both apheresis and reinfusion of c‐PRP had minor impact on the coagulation parameters. Platelet count increased slightly but significantly ( P < 0.05) from 154 to 179 × 10 9 /L after the c‐PRP at wound closure. Preoperative apheresis with an autotransfusion device, separating platelet‐rich plasma and erythrocyte concentrate, is a useful alternative for patients who are unable to utilize the PAD technique for either religious or practical reasons. J. Clin. Apheresis, 15:256–261, 2000. © 2000 Wiley‐Liss, Inc.