Clinical studies of platelet concentrate transfusion in blood primed and non-blood primed cardio-pulmonary bypass
Irako, M.
Nihon Kyobu Geka Gakkai 34(7): 1002-1010
1986
ISSN/ISBN: 0369-4739 PMID: 3772182 Document Number: 281034
For saving blood volume to be required for blood transfusion indispensable to open-heart surgery, platelet concentrate (PC) transfusion was performed against postoperative hemorrhage immediately after operation. Subsequently, Amounts of bleeding blood loss and total transfusion volume after the operation, incidence of postoperative hepatitis and antiplatelet antibody reaction after PC transfusion were examined in 370 patients undergoing open-heart surgery. The patients were divided into the following groups, the PC transfused group and the non-PC transfused group, the blood primed cardio-pulmonary bypass group and the non-blood primed cardio-pulmonary bypass group. The results were as follows. 1. PC transfusion clearly showed an excellent hemostatic effect on postoperative hemorrhage after cardio-pulmonary bypass. PC transfusion has, however, no hemostatic effect in patients with positive antiplatelet antibody. 2. In the non-blood primed cardio-pulmonary bypass group, as compared with the blood primed cardio-pulmonary bypass group, the postoperative bleeding volume was reduced by about 41%, and so we could save the blood of approximately 2000-3000 ml during hospitalization. The incidence of hepatitis complication after transfusion was also reduced by half. 3. No post-transfusion hepatitis was complicated in those having less than 90 minutes of cardiopulmonary bypass time and less than 3000 ml of total transfusion volume in non-blood primed cardiopulmonary bypass. 4. Post-transfusion hepatitis after open-heart surgery was predominant of non-A, non-B type in 92.5%, and 56.7% of them showed a delayed and prolonged course of this disease. All patients with B type hepatitis were completely cured. 5. Antiplatelet antibody reaction was positive only in 6 out of 330 cases examined with the positive rate of 1.8%.