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Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic...

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Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular Anesthesia Department 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
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Page 1: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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

Page 2: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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.

Page 3: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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

Page 4: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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

Page 5: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

Patient Demographics

Demographics and surgical characteristic between two groups were similar.

Page 6: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

Intra-Operative Blood Transfusion

Intra-Operative blood transfusions were significantly reduced in the aPRP cohort .

Page 7: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

Intra-Operative Blood Transfusion

Page 8: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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

Page 9: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

Morbidity

Page 10: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

Time To Extubation

The aPRP group also required reduced ventilator time and were extubated earlier

Page 11: Impact of Autologous Platelet Rich Plasma Transfusion On Clinical Outcomes in Descending Thoracic Abdominal Aortic Aneurysm Repair Cardiothoracic and Vascular.

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.


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