Intraoperative Autologous Platelet-Rich Plasma Collection from the Cardiopulmonary Bypass Circuit

Takeshi Honda, Kazuo Tanemoto, Takahiko Yamasawa, Hiroshi Furukawa

Kawasaki Medical School, Kurashiki, Japan

Date, time and location: 2018.05.26 15:30, Press Hall, 2F

Abstract

Background

The shortage of platelet-rich plasma supplied by blood banks is becoming a serious issue in clinical practice, and autologous platelets are a promising solution. An autologous platelet collection method conducted before the systemic administration of heparin has been reported, but has not been widely employed because it is time consuming. We herein introduced a new method for the collection of autologous platelets from the cardiopulmonary bypass (CPB) circuit.

Materials and Methods

Forty-seven patients who underwent surgery using CPB were included in the present study. Exclusion criteria were anti-platelet agent treatments and abnormally low platelet counts before surgery. Autologous platelets were collected at the beginning of CPB using the Component collection system® by Haemonetics Co., Ltd. Platelet counts and platelet aggregation abilities were measured three times: at the beginning of surgery, after protamine reversal, and after returning the autologous platelet concentrate. Aggregation stimulants were ADP and arachidonic acid.

Results

The mean count of platelets collected in autologous platelet-rich plasma was 5.2 units (1.7~16.0). The mean platelet count decreased from 185.9*1000/μl to 68.9 with cardiopulmonary bypass, but increased to 100.9 following the return of autologous platelet-rich plasma. The platelet aggregation ability (ADP 3.0μM) also decreased from 69.5 to 24.5% after extracorporeal circulation and increased to 33.7% with the administration of autologous platelet-rich plasma. No adverse events were noted in any cases.

Conclusion

Autologous platelet-rich plasma may be safely and effectively collected from the CPB circuit. The platelet count and function immediately increased after the return of autologous platelet-rich plasma. This procedure may be a solution to the future shortage of homologous platelet products supplied by blood banks.