Effect of Platelet-rich Intraoperative Plasmapheresis on the Need for Homologous Blood Use in Coronary Bypass Surgery

Platelet-rich intraoperative plasmapheresis ensures the autotransfusion of undamaged platelets and clotting factors by the end of the operation. To evaluate this technology, 300 randamly selected patients with normal bleeding and clotting tests, who underwent coronary bypass surgery in Siyami Ersek Cardiovascular Surgery Center between 1992 and 1994. were divided into plasmapheresis (n= 150) and control (n= 1 50) groups. Plasmapheresis was begun just after the insertion of Swan-Ganz catheter and ended before the heparinization. The preoperative properties of both groups were similar. The indication for transfusion was a hemoglobin level lower than 7gr/100 ml for the patients younger than 70 years and lower than 8 gr/100 ml for older patients. Mediastinal drainage in the plasmapheresis group was 552 ± 26 cc. and in the control group 760 ± 35 cc. (p<0.01). The mean amount of homologous blood transfusion in the study group was 1,02 units and in the control group 1,9 units (p<0.02). The ratio of patients who did not need transfusion was significantly higher in the study group than the control group with 54,6 % (n=82) and 34,6 % (n=52), respectively (p<0.001). Therefore, this method is useful by reducing the amount of postoperative drainage as well as the need for homologous blood transfusion.