Abstract
ObjectivesThe aim of this study is to evaluate the possibility of the autologous platelet-rich plasma (PRP) collection from the cardiopulmonary bypass (CPB) circuit and to evaluate its effect on the aggregative function.MethodsFor seventy-two patients undergoing cardiac surgery with CPB, an autologous PRP was prepared using the Haemonetics Component Collection System® by drawing blood from the CPB circuit immediately after CPB was established. The blood samples were taken at three points for examination, A: beginning of surgery, B: immediately after heparin reversal with protamine following discontinuation of CPB, C: after the collected autologous PRP was returned to the patient. Platelet count and platelet aggregation ability were analyzed.ResultsThe mean platelet count in autologous PRP was 5.5 (range: 3–14) units. Platelet count decreased by 115.0 (±27.3) × 1000/μl from A to B and increased by 27.3 ± 17.2 (× 1000/μl) from B to C.When platelet aggregation was measured by Adenosine Diphosphate (ADP) 3.0 μM, it decreased by 42.6% ± 12.1% from A to B and increased by 8.7% ± 7.4% from B to C.ConclusionsAutologous PRP can be safely collected by drawing blood from the CPB circuit, platelet count and aggregation ability significantly decreased after CPB including autologous PRP collection. Some improvement was detected in the number of the platelets count and platelet aggregation ability by administrating an autologous PRP even if autologous PRP is collected from CPB circuit.Trial registrationUMI-CTR, UMIN000023776. Registered 1 October 2016.
Highlights
Intraoperative thrombocyte impairment occurs in cardiac surgery due to exposure of blood to the cardiopulmonary bypass circuit; intraoperative thrombocyte impairment affects both thrombocyte count and function [1]
We confirmed that there is no difference in the aggregation ability of autologous platelets collected before and after administration of heparin and that platelet count and platelet function of platelet-rich plasma (PRP) are not affected by heparin administration in animal experiments [4]
Platelet function is reportedly inhibited by various antiplatelet drugs; inhibition of platelet function during administration of heparin has not been shown to occur other than in cases of heparin-induced thrombocytopenia (HIT) [9], in which antibodies promote the production of antiplatelet factor 4 heparin complex antibody, thereby promoting platelet aggregation [10]
Summary
Intraoperative thrombocyte impairment occurs in cardiac surgery due to exposure of blood to the cardiopulmonary bypass circuit; intraoperative thrombocyte impairment affects both thrombocyte count and function [1]. We confirmed that there is no difference in the aggregation ability of autologous platelets collected before and after administration of heparin and that platelet count and platelet function of PRP are not affected by heparin administration in animal experiments [4]. Based on these findings, the aim of this study is to investigate the feasibility and usefulness of autologous platelet collection from the CPB circuit after administration of heparin in clinical cases. Because platelet aggregation ability is used to evaluate the effectiveness of autologous platelet transfusion, the patients with administration of antiplatelet drug were excluded from this study
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