Effectiveness of autologous platelet-rich plasma for blood conservation and its prognostic impact in patients with type A aortic dissection
10.13303/j.cjbt.issn.1004-549x.2025.08.006
- VernacularTitle:自体富血小板血浆对A型主动脉夹层患者血液保护的有效性及预后影响
- Author:
Qian ZHENG
1
;
Shoumei CHEN
1
;
Ming XIE
2
;
Shenshen ZHI
1
;
Kun LIU
1
;
Ting JIANG
1
Author Information
1. Department of Blood Transfusion, Chongqing Emergency Medical Center/Chongqing Fourth People's Hospital, Chongqing 400014, China
2. Department of Cardiothoracic Surgery, Chongqing Emergency Medical Center/Chongqing Fourth People's Hospital, Chongqing 400014, China
- Publication Type:Journal Article
- Keywords:
autologous platelet-rich plasma (aPRP);
type A aortic dissection;
blood conservation;
thromboelastography;
coagulation function
- From:
Chinese Journal of Blood Transfusion
2025;38(8):1035-1042
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the effects of autologous platelet-rich plasma (aPRP) collected using a continuous blood cell separator on blood conservation and prognosis in patients with type A aortic dissection. Methods: The clinical data of patients who underwent emergency aortic replacement for acute type A aortic dissection at our hospital from January 2020 to December 2023 were respectively analyzed. Patients were divided into two groups based on whether they received aPRP collection before surgery for subsequent reinfusion: the aPRP group (n=32) and the control group (n=35). The volume of aPRP collected and the platelet concentration in the aPRP were recorded. The volumes of allogeneic blood and blood products transfused, and the associated costs during hospitalization were compared between two groups. Intraoperative blood loss, perioperative laboratory parameter changes, 24-hour postoperative drainage volume, duration of ICU stay and mechanical ventilation, length of hospital stay, and mortality rate of the two groups were also compared. Results: The platelet concentration in aPRP was (491.5±85.4)×10
/L, accounting for (24.1±9.6)% of the patient's total platelet count. The volume of aPRP collected accounted for (23.0±6.3)% of the patient's total plasma volume. Compared with the control group, the aPRP group demonstrated significantly reduced transfusion volumes of allogeneic red blood cells, plasma, and platelets (P<0.05), along with significantly lower blood-related costs during hospitalization (P<0.05). Postoperative coagulation parameters (APTT, PT, INR, and TEG) were significantly improved (P<0.05), and platelet counts were markedly increased (P<0.05) in aPRP group as compared with the control group. No statistically significant differences were observed in postoperative use of prothrombin complex concentrate and fibrinogen between the two groups. Similarly, there were no significant differences in postoperative 24-hour drainage volume, 24-hour extubation rate, ICU length of stay, duration of mechanical ventilation, or total hospital length of stay. The incidence of complications and mortality did not differ significantly between the two groups. Conclusion: The administration of aPRP significantly reduces the requirement for perioperative allogeneic blood transfusion in patients undergoing surgery for type A aortic dissection. Furthermore, it enhances coagulation function and reduces associated transfusion costs, thereby establishing itself as an effective and safe strategy for blood conservation.
