Homologous Blood Transfusion Research Articles

Impact of a cell salvage device on blood transfusions to dogs undergoing surgery at a referral veterinary hospital.

To determine the number of homologous blood transfusions received by canine surgical patients after introducing a cell salvage device (CSD), trends in surgeries requiring blood transfusion, and the incidence of transfusion reactions. Retrospective study. Single referral hospital. All dogs having surgery at a single center (November 2015 to February 2021). Medical records of dogs having surgical treatment, including those that received either an autologous or homologous blood transfusion, were reviewed. The surgical patients were the baseline population, and the 2 transfusion groups were compared within this population to analyze the trends. A total of 37 and 86 dogs received autologous and homologous blood transfusions, respectively. There was an upward trend in the number of total monthly blood transfusions. No significant increase in the monthly number of homologous transfusions was observed before or after acquisition of the CSD. There was also an upward trend in total monthly surgeries, including those with higher risks of hemorrhage. Dogs receiving homologous blood transfusions had a higher incidence of clinical signs consistent with transfusion reactions (6.98%). An upward trend in autologous blood transfusions was seen with the introduction of a CSD. Hospitals with large surgical caseloads at high risk of hemorrhage may see a decreased need for outsourced blood products with the use of the CSD. The device can lead to a more responsible use of an increasingly scarce resource and decrease the risk of a blood transfusion reaction in dogs.

Homologous blood transfusion and doping: Where are we now?

Homologous blood transfusion (HBT) is used for doping in endurance sports since the 1960s. The blood comes from a compatible donor, that is, someone with a compatible ABO and rhesus blood group. Despite been prohibited by the IOC in 1985, no detection method was available until 2003. Then came the idea to use red blood cells (RBC) minor blood groups antigens that constitute an "identity" card of someone's RBC to detect the presence of a second RBC population. The method validated for doping control samples uses flow cytometry after incubation of isolated RBC with eight to 12 primary antibodies against specific minor blood groups antigens. The presence of double populations of RBC is revealed by a major and a minor peak in a fluorescence histogram. The sensitivity was estimated sufficient to detect HBT for a few weeks. Despite the complexity and cost of the method, right after its application in 2004, several cases of HBT were identified but the number of cases dropped rapidly over the years. In the 2010s, other ways to detect HBT were developed and evaluated: indirect detection using the Athlete Biological Passport approach, and a few years later forensic DNA analysis to establish the presence of two different DNA in a blood sample after HBT. Despite the high specificity of the latter, the sensitivity was recently questioned in vivo. Nowadays, the flow cytometry method remains the method of choice for HBT detection and recent investigations helped to simplify the method and increase its specificity and sensitivity.

A SNP-based genotyping strategy to detect the abuse of homologous blood transfusion from dried blood spots.

We performed genotyping analysis of human biallelic polymorphisms (single nucleotide polymorphisms) for the detection of homologous blood transfusion in sports doping. DNA was extracted from dried blood spots and quantified real-time fast PCR. The method was proven to allow the detection of transfusions up to a donor percentage of 1%, with a significant improvement in terms of sensitivity with respect to both the reference cytofluorimetric method and a previously proposed strategy based on the DNA STR-based strategy.

Physiologic postoperative presepsin kinetics following primary cementless total hip arthroplasty: A prospective observational study.

Presepsin is an emerging biomarker in the diagnosis of sepsis. In the field of orthopaedics, it could be useful in diagnosing and managing periprosthetic joint infections. To define the normal postoperative presepsin plasmatic curve, in patients undergoing primary cementless total hip arthroplasty (THA). Patients undergoing primary cementless THA at our Institute were recruited. Inclusion criteria were: Primary osteoarthritis of the hip; urinary catheter time of permanence < 24 h; peripheral venous cannulation time of permanence < 24 h; no postoperative homologous blood transfusion administration and hospital stay ≤ 8 d. Exclusion criteria were: The presence of other articular prosthetic replacement or bone fixation devices; chronic inflammatory diseases; chronic kidney diseases; history of recurrent infections or malignant neoplasms; previous surgery in the preceding 12 mo; diabetes mellitus; immunosuppressive drug or corticosteroid assumption. All the patients received the same antibiotic prophylaxis. All the THA were performed by the same surgical and anaesthesia team; total operative time was defined as the time taken from skin incision to completion of skin closure. At enrollment, anthropometric data, smocking status, osteoarthritis stage according to Kellgren and Lawrence, Harris Hip Score, drugs assumption and comorbidities were recorded. All the patients underwent serial blood tests, including complete blood count, presepsin (PS) and C-reactive protein 24 h before arthroplasty and at 24, 48, 72 and 96 h postoperatively and at 3, 6 and 12-mo follow-up. A total of 96 patients (51 female; 45 male; mean age = 65.74 ± 5.58) were recruited. The mean PS values were: 137.54 pg/mL at baseline, 192.08 pg/mL at 24 h post-op; 254.85 pg/mL at 48 h post-op; 259 pg/mL at 72 h post-op; 248.6 pg/mL at 96-h post-op; 140.52 pg/mL at 3-mo follow-up; 135.55 pg/mL at 6-mo follow-up and 130.11 pg/mL at 12-mo follow-up. In two patients (2.08%) a soft-tissue infection was observed; in these patients, higher levels (> 350 pg/mL) were recorded at 3-mo follow-up. The dosage of plasmatic PS concentration is highly recommended in patients undergoing THA before surgery to exclude the presence of an unknown infection. The PS plasmatic concentration should be also assessed at 72 h post-operatively, evaluate the maximum postoperative PS value, and at 96 h post-operatively when a decrease of presepsin should be found. The lack of a presepsin decrease at 96 h post-operatively could be a predictive factor of infection.

Comparison of the effects of autologous and non-autologous blood transfusions on the advantages, disadvantages, extubation time and bleeding after coronary bypass

PurposeBlood transfusion; is considered an organ transplant. In coronary bypass surgery, large volumes of homologous blood transfusion may be required due to excessive bleeding. The large number of use of homologous blood transfusion in open heart surgery and the awareness of its various harmful effects have prompted researchers to conduct research on the use of autologous blood. With autologous transfusion, blood diseases, incompatibility, immunosuppression and organ damage can be prevented and the patient can be extubated earlier in the postoperative period. MethodsBetween January 2020 and January 2016, a total of 176 patients, 56 in the treatment group (with autologous blood transfusion) and 120 in the control group, whose information could be reached from hospital records were investigated retrospectively. ResultsNo statistical difference was found between the mean intubation SO2 and PO2 values of the groups. On the contrary, considering the mean intubation times in the intensive care unit of both groups, the patients who underwent autologous blood transfusion were extubated at a statistically significant earlier time. ConclusionAutologous blood transfusion is a safe method in selected patients as well. Thanks to this method, patients are protected from complications associated with homologous blood transfusion. It is believed that performing autologous blood transfusion in selected patients undergoing open-heart surgery can decrease the number of postoperative transfusions, frequency of transfusion-related complications (especially in the lungs), and mean intubation times.

Evaluation of the detection of the homologous transfusion of a red blood cell concentrate in vivofor antidoping.

Two doping cases of homologous blood transfusion (HBT) during Tokyo 2020 Summer Olympics have shown that more controls are needed. The method of detection using flow cytometry to evaluate the expression of minor blood group antigens from red blood cells (RBCs) and identify different RBC populations is efficient but still complex to perform with multiple antigens detection. Recently, the interest of using forensic DNA analysis was also highlighted as a potential new method to detect HBT, with possibility to start from dried blood spots (DBS) instead of fresh blood. After a first phase of development, a protocol was validated for HBT detection using DNA analysis after extraction from DBS. Presence of a second DNA was clear down to 2% of donor blood in vitro. A flow cytometry protocol was also developed with preparation and analysis in 96-well plates and detection of two different antigens per well using two secondary antibodies with distinct fluorophores. The objective of the project was to evaluate the window of detection of an HBT performed in vivo with 150 mL of RBC concentrate. Blood samples obtained over 7 weeks post-transfusion were analyzed. DNA profiling from DBS was not sensitive enough to detect the presence of a second DNA even 1 day after transfusion. On the contrary, the flow cytometry protocol was very efficient and allowed identification of several double populations of RBC (expressing/non-expressing several antigens) until day 50 post-transfusion. This protocol can be fully validated for a future application to doping control samples.

Retrograde Autologus Priming and its Effects on Intraoperative Transfusion

Introduction: Extreme haemodilution going on with cardiopulmonary pass imposes an vital chance element recollect for blood transfusion in cardiac surgical patients. Priming of the cardiopulmonary bypass circuit with sufferers' own blood [retrograde autologous priming (RAP)] is a system used to restrict haemodilution and decrease transfusion requirements. Objective: The objective of our study was to evaluate the effects of Retrograde Autologus Priming on reducing intraoperative blood transfusion in cardiac surgery. Methodology: It was cross sectional study, conducted over a period of six month from august 2021- February 2022 at Peshawar Institute of Cardiology, department of cardiac surgery. We enrolled one hundred and sixty patients, n= (160) through prestructured Performa by the use of non-probability convenient sampling method technique. Results: The mean age of the patients (8.77±8.644), mean HB before surgery (13.443±2.9020), after surgery (10.947±2.0891), haematocrit after surgery (34.98±7.697), priming volume (549.32±229.013), effective priming volume (539.69±257.563), extubation time (3.91±1.255) and ICU stay was (2.20±.875). Post-op performance HB level, hematocrit, priming volume, extubation time and ICU stay shows a significant association at p value &lt;0.05. Conclusion: According to the results of our study, it is concluded that reducing CPB priming volume by the RAP techniques reduces homologous blood transfusion in congenital and valvular defect patients. It also shows that RAP technique shows significant association to the postoperative performance of the patients at p-value &lt;0.05.

Bilateral medial sacrospinous ligament suture for apical suspension through natural spaces: A single-center study with low perioperative complications.

Sacrospinous ligament fixation (SSLF) is one of the most used native tissue approaches for apical suspension with a high rate of perioperative complications. This study aimed to review cases undergoing a modified SSLF and assess its perioperative adverse events. It was a retrospective study of 168 consecutive patients undergoing modified transvaginal SSLF at a single tertiary center from 2017 to 2021. The sutures were placed on the sacrospinous ligament (SSL) approaching the sacrum through natural spaces under direct vision. Moreover, it was performed bilaterally. Patient demographics and perioperative complications were reviewed. The median age was 65 years, and 85.7% (144/168) had stage III-IV prolapse. Among the 168 patients undergoing this modified SSLF, 161 were for uterovaginal prolapse, and seven were for posthysterectomy vaginal vault prolapse. 83.9% (135/161) patients were concomitant with hysterectomy, and 70.2% (118/168) were with anteroposterior colporrhaphy. The median operation time was 82 min (interquartile range [IQR], 61-100 min), and the median intraoperative blood loss was 50 ml (IQR, 30-50 ml). Two cases had pelvic hematoma, and both were cured after expectant treatment. No patient required a homologous blood transfusion, and none complained about buttock or lower limb pain 2 weeks postoperatively. Nor did injury of the ureters, bladder, or rectum occur intraoperatively. This modified transvaginal SSLF procedure was safe and had no severe perioperative complications.

Doping control analyses during the Tokyo 2020 Olympic and Paralympic Games.

The doping control analyses at the XXXII Olympic Games (July 23 to August 8, 2021) and the XVI Paralympic Games (August 24 to September 5, 2021) held in Tokyo, Japan, after a year of delay due to the COVID-19 pandemic are summarized in this paper. A new satellite facility at the existing World Anti-Doping Agency (WADA)-accredited Tokyo laboratory was established and fully operated by 278 staff, including 33 Tokyo laboratory staff, 49 international experts, and 196 Japanese temporary staff. The numbers of urine samples were 5081 (Olympics) and 1519 (Paralympics), and the numbers of blood samples were 1103 (Olympics) and 500 (Paralympics). The laboratory could prepare for analysis in advance using a paperless chain-of-custody system, allowing for faster turnaround time reporting. For the first time, a new polymerase chain reaction method for detecting erythropoietin (EPO) gene doping was used. The laboratory also analyzed blood samples for detecting steroid esters following the spotting of collected venous EDTA blood onto dried blood spot cards. Moreover, full-scan data acquisition using high-resolution mass spectrometers was performed for all urine samples, allowing for detecting traces of doping substances, which are not currently analyzed in the subsequent data processing. The presence of some prohibited substances was confirmed, resulting in 8 atypical findings (ATFs) and 11 adverse analytical findings (AAFs), including homologous blood transfusion (2 cases) and recombinant EPO in the blood (1 case), at the Olympics, whereas 2 ATFs and 10 AAFs were reported at the Paralympics.

Blood Conservation in Anaesthesia and Surgery - A Review

Dangers to blood transfusion exist even when stringent methods are used to screen blood before transfusion. These dangers include blood transfusion reactions and the transmission of bacteria, viruses and protozoa to patients. Blood conservation adopts strategies that restrict the transfusion of homologous blood to patients. Conservation starts in the preoperative period and includes the diagnosis and management of anaemia. Augmentation of the preoperative haemoglobin can be achieved by using a combination of iron preparations, vitamins, protein supplementation, erythropoietin and treatment for malaria in suspected patients. Maintenance of the intravascular volume during surgery can be achieved using colloids and crystalloids. Blood conservation techniques, including induced hypotension, use of anti-fibrinolytics and acceptable forms of autologous blood transfusion reduce the need for allogeneic blood transfusion. Blood conservation methods are also important in critically ill patients and includes, accepting lower haemoglobin levels, restricting the amount of blood taken during phlebotomy and the use of erythropoietin/erythropoietin receptor agonists.

Elective Coronary Artery Bypass Graft Surgery Using Reduced Homologous Blood Transfusion

Elective Coronary Artery Bypass Graft Surgery Using Reduced Homologous Blood Transfusion

AUTOLOGOUS TRANSFUSION IN LARGE VOLUME LIPOSUCTION. COHORT FOLLOW-UP.

INTRODUCTION: With the increased knowledge about the physiology of liposuction, procedures that involve larger body surface area are now being performed, which means an increased risk of hemorrhage and the need for transfusion. Homologous blood transfusion poses well-known risks, prompting the use of alternative and safer techniques such as autologous donation. To demonstrate the utility of autologousOBJECTIVE: transfusion in a cohort of patients undergoing large volume liposuction. Observational, retrospective andMETHODS: longitudinal cohort study in patients undergoing liposuction, in the period 2017-2021. Autologous donation was performed one month and two weeks prior to surgery, ensuring that all patients were prescribed medication and prophylactic dietary measures to avoid hemoglobin depletion. 40 les of women between 26 and 46 years of age, with a bodyRESULTS AND CONCLUSIONS: mass index between 24 and 30 m/kg2 and a median aspirated volume of 6.3 Lt were analyzed. Quantied bleeding averaged 675 cc. Both initial hemoglobin and hematocrit had statistically signicant differences with values in the postoperative period (pn all. However, vital signs remained stable and no transfusion-associated adverse events occurred. Autologous transfusion is an excellent strategy for the management of bleeding in large volume liposuction.

Detection of Homologous Blood Transfusion in Sport Doping by Flow Cytofluorimetry: State of the Art and New Approaches to Reduce the Risk of False-Negative Results.

This article presents the results of a study aimed to give new suggestions and strategies for improving the implementation of the flow cytofluorimetry-based method for the detection of homologous blood transfusions in doping control. The method is based on the recognition of the phenotypic mismatch between minority blood group antigens possessed by the donor and the recipient. Two strategies have been followed to reduce the risk of false-negative results: (i) the monitoring of a broader range of erythrocytes surface antigens; and (ii) the application of different surface erythrocyte staining protocols, tailored on the different antigens and the type of antigenic mismatch that had to be detected (whether it is the donor or the recipient who expresses or not the antigen to be detected). Special attention has also been focused on the time factor, to avoid prolonged sample storage, since hemolysis may have a significant impact on the reliability and quality of the results. Our experimental evidence suggests that the risk of false-negative results can be minimized by (i) the expansion of the antigen panel, with the inclusion of four additional targets; (ii) a more accurate selection of the gating area of the red blood cells; (iii) the choice of a better fluorochrome (alexa fluor 488) to be conjugated to the secondary antibody; and (iv) the implementation of different staining protocols depending on the nature of the double population to be detected (donor expressing vs. recipient non-expressing and vice versa). The combination of the above approaches allowed a significant reduction of false-negative results, assessed on samples simulating a homologous blood transfusion between two compatible subjects.

Study of efficacy and compliance of iron sucrose in iron deficiency anaemia in pregnancy

A prospective study conducted at Apollo Medical College & Hospital to study the intravenous iron sucrose efficacy in moderate iron deficiency anemia in pregnancy in patients between 14-34 weeks of gestational age.100 patients with moderate iron deficiency anemia with hemoglobin between 7 -10 gm/dl and serum ferritin less than 15mg/ltand peripheral blood picture showing microcytic hypochromic anemia were included in the current study. Majority patients were multiparous with a mean age of 22.9 years and gestational period of 30-34weeks. 60% were vegetarians and 40% non -vegetarians in the present study. Out of100 patients, 70% were from rural area whereas 30% were from urban area. In the present study the mean change of pre-treatment and post- treatment heamoglobin level is found to be 1.6460 which is statistically significant. The median of pre-treatment and post treatment serum ferritin level is found to be 132.2680 which is statistically significant. Largely Iron sucrose can be a treatment of choice with no serious side effects and is indicated for correction of anemia in pregnancy or restoring maternal iron stores. Hence intravenous iron sucrose treatment will certainly help to reduce risk of homologous blood transfusions and correction of anemia.

Improving the Detection of Homologous Blood Transfusion in Sport Doping: A Full DNA‐based Genotyping Strategy on Dried Blood Spots

Homologous blood transfusions (hBT) are prohibited in sport by the World Anti-Doping Agency (WADA) as they represent one of the illicit strategies that athletes can pursue to improve the oxygen supply to the tissues, with a consequent enhancement of the athletic performance. The current method of detection of hBT is based on the phenotypic mismatch analysis of red blood cells (RBC) surface antigens by flow cytofluorimetry. Despite the excellent sensitivity and specificity of the method, some critical issues have progressively emerged, mostly related ti the relatively high risk of false-negative results. At the same time, the method is not applicable to blood samples collected as “dried blood spots”. To overcome these difficulties, we designed and developed a detection strategy based on DNA analysis. The wide inter-individual variability of DNA genotypes allows to completely eliminate the problem represented by the “false negative” results, improving also the overall sensitivity of the anti-doping tests. Our method is based on a combination of the forensic typing of DNA with the genotyping of SNP genetic polymorphisms. The effectiveness of the proposed approach has been confirmed by the analysis of positive samples obtained by mixing whole blood from two different compatible donors, who shared the same panel of RBC surface antigens, collected on DBS cards. DNA was isolated by a DNA forensic extraction kit based on magnetic beads. Our results suggest that the proposed approach, once validated on samples from real transfused subjects, can complement the current testing strategy based on the mismatch of the RBC surface antigens.

Introduction of a ROTEM-assisted strategy improves patient blood management in children undergoing open craniosynostosis repair

Purpose The surgical correction of craniosynostosis by open cranial vault reconstruction (OCVR) is often associated with significant blood loss and perioperative blood transfusion demand. Because of transfusion risks, several attempts have been made to eliminate the need for perioperative homologous blood transfusion with the implementation of goal-directed transfusion protocols. The aim of this study was to determine whether the introduction of a rotational thromboelastometry (ROTEM)–assisted patient blood management strategy would decrease the intraoperative blood transfusion and blood loss levels. Methods Patients younger than 2 years of age who were diagnosed with nonsyndromic single suture synostosis and underwent primary OCVR were investigated in this retrospectively designed cohort study. The children were equally divided into 2 study groups according to the availability of the ROTEM-assisted protocol. The control group had surgery before introduction of the new protocol, whereas the study group was operated on subsequently. Demographic, blood loss, and transfusion data of the preprotocol cohort were compared with those of the postprotocol cohort. Results In total, 100 children, separated in 2 groups (50 patients each), were analyzed. The mean age at the time of surgery was 8.5 months in the pre-ROTEM-assisted protocol group, and 8.7 months in the postimplementation group. The estimated blood volume loss dropped from 60.8 mL/kg to 49.6 mL/kg after initiation of the current strategy. The intraoperative packed red blood cell (PRBC) transfusion volume decreased from 32.6 mL/kg to 17.1 mL/kg. Administration of PRBCs in the postoperative period also was reduced, compared with the period before implementation of the ROTEM-assisted regimen, from 21.8 mL/kg to 15.9 mL/kg. The average length of hospital stay was reduced from 5.4 days to 4.7 days after use of the ROTEM-assisted protocol. Conclusions As indicated by our results, the use of a ROTEM-assisted protocol is associated with considerable reduction in blood volume loss and perioperative allogeneic transfusion requirements in the surgical management of craniosynostosis with OCVR.

Effect of acute normovolemic hemodilution on coronary artery bypass grafting: A systematic review and meta-analysis of 22 randomized trials.

Efficacy of minimal acute normovolemic hemodilution (ANH) in avoiding homologous blood transfusion during cardiovascular surgery remains controversial. Postoperative bleeding and transfusion remain a source of morbidity and cost after open heart operations. To better understand the role of acute normovolemic hemodilution (ANH) in coronary artery bypass grafting (CABG), we compared ANH with standard intraoperative care in a systematic review including a standard pairwise meta-analysis of randomized controlled trials (RCTs). We searched the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese National Knowledge Infrastructure (CNKI) up to April 1, 2020. The primary outcome was to assess the incidence of ANH-related number of allogeneic red blood cell units (ARBCu) transfused. Secondary outcomes included the rate of allogeneic blood transfusion and estimated total blood loss. A total of 22 RCTs including 1688 patients were identified for the present meta-analysis. Of these studies, 19 were about CABG with on-pump and three with off-pump. Our pooled result indicated that patients received ANH experienced fewer ARBCu transfusions, with a standardized mean difference (SMD) of -0.60 (95%CI -0.96 to -0.24; P=0.001). The rate of allogeneic blood transfusion in ANH group was significant reduced when compared with controls, with a relative risk (RR) of 0.65 (95%CI 0.52 to 0.82; P=0.0002). In addition, less postoperative estimated total blood loss was present, with a SMD of -0.53 (95%CI -0.88 to -0.17; P=0.004). The present meta-analysis indicated that ANH could reduce the number of ARBCu transfused in the CABG surgery setting. In addition, ANH could also reduce the rate of ARBCu transfusion and estimated total blood loss for CABG patients.

Preoperative Management of a Jehovah's Witness Patient Undergoing Head and Neck Surgery With High Risk of Bleeding.

Surgery in head and neck district is often associated with bleeding as major complication and need of blood transfusions. Homologous blood transfusions may be unacceptable to some patient groups such as the Jehovah's Witness (JW) patients. Refusal of potentially life-saving treatment creates ethical dilemmas for treating clinicians.This is the first report in literature which examines the management and treatment of a female JW patient who underwent major surgical procedure for squamous cell carcinoma of the jaw with a high risk of hemorrage which rejected any possibility of blood and hemocomponent transfusion by virtue of her religious principles.

Retrograde autologous priming RAP reduces deep hemodilution during cardiopulmonary bypass CPB

Immediate hemodilution and rapid decrease in osmotic pressure at the time of CBP onset are associated with the aforementioned organic dysfunctions. Decreased osmotic pressure increases effective filtration pressure and microvascular filtration. Consequently, an increase in pulmonary interstitial fluid and myocardial edema is observed after discontinuation of CBP. Retrograde autologous priming (RAP) is a means to effectively and safely restrict the hemodilution caused by the direct homologous blood transfusion and reduce the blood transfusion requirements during cardiac surgery. Materials and Methods The study included 40 patients scheduled to undergo coronary surgical revascularization, divided into two groups: the RAP group and the non-RAP group. The average age in both groups is 55 years (SD 5). Conclusion A significant benefit was observed between the two groups in the study regarding the amount of transfused blood (1.55 -SD 0.88) / (2.15 -SD 0.81). This is a very important fact in favor of using the RAP technique, taking into account the reduction of the risk for complications carried by heterologous transfusion. Also, a significant reduction in the use of donated blood at a time when the problems of blood insufficiency in the collection centers are known, is equally important. The hospitalization (days of staying) in the ICU is also significantly lower in the RAP group (2.6 -SD 0.68) / (3.1-SD 0.64). This should be related to the faster activation of RAP in patients as a result of faster return to normal weight (with less fluid load), better ventilator function, and faster decline of cerebral edema. Keywords : Retrograde autologous priming (RAP), hemodilution, cardiopulmonary bypassCPB) DOI: 10.7176/ALST/81-04 Publication date: August 31 st 2020

Autologous Priming of Cardiopulmonary Bypass in Adult Patients, Effect on Blood Transfusion, Hemodilution and its Effect on Body Systems

Abstract Background: Development of many techniques conserve blood in cardiac surgery has been established, to avoid the side effects of homologous blood transfusion. One of these techniques is the Retrograde Autologous Priming (RAP); which is a blood conservation technique designed to decrease the severity of hemodilution during cardiopulmonary bypass and thus decreasing perioperative transfusions. Aim of Study: The aim was to examine the safety and efficacy of RAP and its role in decreasing adverse outcomes on body systems after cardiac surgery. Patients and Methods: This work was performed on 60 adult patients indicated for open heart surgery as valvular heart disease or coronary heart disease. 30 patients were operated using RAP technique and 30 patients using ordinary priming method of cardiopulmonary bypass (CPB). Results: The CPB mean time was significantly shorter in the RAP group. The hemoglobin (Hb) level and hematocrit (Hct) concentration in the perioperative and postoperative time as significantly higher in the RAP group also the platelet count was significantly higher in the RAP group (p 0.05) between the two groups. Conclusions: RAP is an efficient and economical method in limiting the amount of priming volume of the CPB system, causing less hemodilution, reducing intra- and postoperative blood transfusion and decreasing adverse effects of hemodi-lution on body systems.