The influence of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patients: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Lili , SHI Wei , FU Min , XING Changshuang ,  MA Haiping

The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, P.R.China;

Corresponding author：

MA Haiping, Email: 137806086@qq.com

Keywords：

Cardiac surgery; autologous platelet transfusion; complications; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202009005

Video：

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Objective To explore the effects of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patient.Methods Using the method of systematic review of Cochrane Collaboration, we searched PubMed, Web of Science, EMbase, The Cochrane Library, CNKI and Wangfang databases, retrieving the literature from January 1970 to June 2020 to collect clinical randomized controlled trials on the effects of autologous platelet transfusion on complications and prognosis of adult cardiac surgery patients. The extracted valid data was analyzed by RevMan5.3 software.Results Ten studies were included, with a total of 1 083 patients. The results of meta-analysis showed that there were statistical differences in the perioperative blood loss (MD=−195.15, 95%CI −320.48-−69.83, P=0.002) and perioperative blood transfusion (MD=−0.88, 95%CI −1.23-−0.52, P<0.001). There was no statistical difference in the death rate 30 days after the operation (RR=0.90, 95%CI 0.48-1.70, P=0.75), reoperations (OR=0.48, 95%CI 0.23-1.02, P=0.06), postoperative myocardial infarction (OR=1.29, 95%CI 0.48-3.51, P=0.61), postoperative infection (OR=1.71, 95%CI 0.89-3.29, P=0.11) or postoperative ICU retention time (MD=−0.31, 95%CI −0.67-0.05, P=0.09).Conclusion Perioperative autologous platelet transfusion can reduce perioperative blood loss and blood transfusion in adult cardiac surgery patients, but has no significant impact onprognosis and postoperative complications, which indicates that perioperative autologous platelet transfusion is a safe and beneficial blood protection measure for patients undergoing cardiac surgery.

Citation： LI Lili, SHI Wei, FU Min, XING Changshuang, MA Haiping. The influence of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patients: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(6): 729-734. doi: 10.7507/1007-4848.202009005 Copy

1.	Tomar AS, Tempe DK, Banerjee A, et al. Preoperative autologous plateletpheresis in patients undergoing open heart surgery. Ann Card Anaesth, 2003, 6(2): 136-142.
2.	袁辉, 黄维勤, 袁世荧. 自体血小板分离在大血管手术中的血液保护作用. 中国心血管病研究, 2016, 14(11): 1030-1034.
3.	石晟, 王古岩. 自体血小板分离技术用于心脏瓣膜手术的前瞻随机对照研究. 中国分子心脏病学杂志, 2019, 19(4): 2976-2979.
4.	李沅敏, 周健, 周耀铨, 等. 自体血小板分离回输对体外循环心脏直视手术患者血液的保护作用. 同济大学学报(医学版), 2016, 37(5): 44-46, 53.
5.	Tian WZ, Er JX, Liu L, et al. Effects of autologous platelet rich plasma on intraoperative transfusion and short-term outcomes in total arch replacement (Sun's procedure): A prospective, randomized trial. J Cardiothorac Vasc Anesth, 2019, 33(8): 2163-2169.
6.	Zhou SF, Estrera AL, Loubser P, et al. Autologous platelet-rich plasma reduces transfusions during ascending aortic arch repair: a prospective, randomized, controlled trial. Ann Thorac Surg, 2015, 99(4): 1282-1290.
7.	Reade MC, Marks DC, Bellomo R, et al. A randomized, controlled pilot clinical trial of cryopreserved platelets for perioperative surgical bleeding: the CLIP-Ⅰ trial (Editorial). Transfusion, 2019, 59(9): 2794-2804.
8.	Christenson JT, Reuse J, Badel P, et al. Plateletpheresis before redo CABG diminishes excessive blood transfusion. Ann Thorac Surg, 1996, 62(5): 1373-1378.
9.	Dörge H, Sellin C, Bury MC, et al. Incidence of deep sternal wound infection is not reduced with autologous platelet rich plasma in high-risk cardiac surgery patients. Thorac Cardiovasc Surg, 2013, 61(3): 180-184.
10.	Gunaydin S, McCusker K, Sari T, et al. Clinical impact and biomaterial evaluation of autologous platelet gel in cardiac surgery. Perfusion, 2008, 23(3): 179-186.
11.	Wajon P, Gibson J, Calcroft R, et al. Intraoperative plateletpheresis and autologous platelet gel do not reduce chest tube drainage or allogeneic blood transfusion after reoperative coronary artery bypass graft. Anesth Analg, 2001, 93(3): 536-542.
12.	St-Onge S, Lemoine É, Bouhout I, et al. Evaluation of the real-world impact of rotational thromboelastometry-guided transfusion protocol in patients undergoing proximal aortic surgery. J Thorac Cardiovasc Surg, 2019, 157(3): 1045-1054.
13.	Sniecinski RM, Levy JH. Bleeding and management of coagulopathy. J Thorac Cardiovasc Surg, 2011, 142(3): 662-667.
14.	Velasquez CA, Singh M, Bin Mahmood SU, et al. The effect of blood transfusion on outcomes in aortic surgery. Int J Angiol, 2017, 26(3): 135-142.
15.	林培容, 侯宇希, 赵嘉美, 等. 自体血小板分离回输对复杂主动脉弓部手术患者围术期全身炎症反应的影响. 心肺血管病杂志, 2016, 35(6): 449-452.
16.	Alberts M, Bandarenko N, Gaca J, et al. Reduced use of allogeneic platelets through high-yield perioperative autologous plateletpheresis and reinfusion. Transfusion, 2014, 54(5): 1348-1357.
17.	Sbarouni E, Georgiadou P, Analitis A, et al. Significant changes in platelet count, volume and size in acute aortic dissection. Int J Cardiol, 2013, 168(4): 4349-4350.
18.	巫红梅, 黄志锋. 术前自体血小板分离对复杂成人先天性心脏病手术的血液保护效果. 岭南心血管病杂志, 2020, 26(3): 292-296.

1. Tomar AS, Tempe DK, Banerjee A, et al. Preoperative autologous plateletpheresis in patients undergoing open heart surgery. Ann Card Anaesth, 2003, 6(2): 136-142.
2. 袁辉, 黄维勤, 袁世荧. 自体血小板分离在大血管手术中的血液保护作用. 中国心血管病研究, 2016, 14(11): 1030-1034.
3. 石晟, 王古岩. 自体血小板分离技术用于心脏瓣膜手术的前瞻随机对照研究. 中国分子心脏病学杂志, 2019, 19(4): 2976-2979.
4. 李沅敏, 周健, 周耀铨, 等. 自体血小板分离回输对体外循环心脏直视手术患者血液的保护作用. 同济大学学报(医学版), 2016, 37(5): 44-46, 53.
5. Tian WZ, Er JX, Liu L, et al. Effects of autologous platelet rich plasma on intraoperative transfusion and short-term outcomes in total arch replacement (Sun's procedure): A prospective, randomized trial. J Cardiothorac Vasc Anesth, 2019, 33(8): 2163-2169.
6. Zhou SF, Estrera AL, Loubser P, et al. Autologous platelet-rich plasma reduces transfusions during ascending aortic arch repair: a prospective, randomized, controlled trial. Ann Thorac Surg, 2015, 99(4): 1282-1290.
7. Reade MC, Marks DC, Bellomo R, et al. A randomized, controlled pilot clinical trial of cryopreserved platelets for perioperative surgical bleeding: the CLIP-Ⅰ trial (Editorial). Transfusion, 2019, 59(9): 2794-2804.
8. Christenson JT, Reuse J, Badel P, et al. Plateletpheresis before redo CABG diminishes excessive blood transfusion. Ann Thorac Surg, 1996, 62(5): 1373-1378.
9. Dörge H, Sellin C, Bury MC, et al. Incidence of deep sternal wound infection is not reduced with autologous platelet rich plasma in high-risk cardiac surgery patients. Thorac Cardiovasc Surg, 2013, 61(3): 180-184.
10. Gunaydin S, McCusker K, Sari T, et al. Clinical impact and biomaterial evaluation of autologous platelet gel in cardiac surgery. Perfusion, 2008, 23(3): 179-186.
11. Wajon P, Gibson J, Calcroft R, et al. Intraoperative plateletpheresis and autologous platelet gel do not reduce chest tube drainage or allogeneic blood transfusion after reoperative coronary artery bypass graft. Anesth Analg, 2001, 93(3): 536-542.
12. St-Onge S, Lemoine É, Bouhout I, et al. Evaluation of the real-world impact of rotational thromboelastometry-guided transfusion protocol in patients undergoing proximal aortic surgery. J Thorac Cardiovasc Surg, 2019, 157(3): 1045-1054.
13. Sniecinski RM, Levy JH. Bleeding and management of coagulopathy. J Thorac Cardiovasc Surg, 2011, 142(3): 662-667.
14. Velasquez CA, Singh M, Bin Mahmood SU, et al. The effect of blood transfusion on outcomes in aortic surgery. Int J Angiol, 2017, 26(3): 135-142.
15. 林培容, 侯宇希, 赵嘉美, 等. 自体血小板分离回输对复杂主动脉弓部手术患者围术期全身炎症反应的影响. 心肺血管病杂志, 2016, 35(6): 449-452.
16. Alberts M, Bandarenko N, Gaca J, et al. Reduced use of allogeneic platelets through high-yield perioperative autologous plateletpheresis and reinfusion. Transfusion, 2014, 54(5): 1348-1357.
17. Sbarouni E, Georgiadou P, Analitis A, et al. Significant changes in platelet count, volume and size in acute aortic dissection. Int J Cardiol, 2013, 168(4): 4349-4350.
18. 巫红梅, 黄志锋. 术前自体血小板分离对复杂成人先天性心脏病手术的血液保护效果. 岭南心血管病杂志, 2020, 26(3): 292-296.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

The influence of perioperative autologous platelet transfusion on postoperative complications and prognosis of adult cardiac surgery patients: A systematic review and meta-analysis

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