• Wen-Zhi Tian, Jian-Xu Er, Liang Liu, Qing-Liang Chen, and Jian-GeHan Han.
• Department of Anesthesiology, Tianjin Chest Hospital, Tianjin Cardiovascular Diseases Institute, Tianjin, China.
• J. Cardiothorac. Vasc. Anesth. 2019 Aug 1; 33 (8): 2163-2169.

ObjectiveTo observe the effect of collecting and retransfusing autologous platelet rich plasma (aPRP) on the amount of allogeneic blood usage in total arch replacement (Sun's surgery) and the outcomes 30 days after surgery.DesignA prospective, randomized trial.SettingA tertiary university hospital specialized in cardiovascular diseases.ParticipantsThe study comprised 120 patients undergoing Sun's surgery for Stanford type A acute aortic dissection.InterventionsaPRP was harvested before incision and was re-transfused after heparin neutralization for patients in the treatment group.Measurements And Main ResultsThere was no significant difference in preoperative demographic data between the 2 study groups. Intraoperative transfusions of erythrocyte (p = 0.009), plasma (p = 0.017), cryoprecipitate (p = 0.002), and platelets (p < 0.001) in the treatment group were reduced significantly. In addition, less blood loss was observed in the treatment group (p = 0.002). The durations of postoperative mechanical ventilation (p = 0.029) and hospitalization (p = 0.002) of the treatment group were significantly shorter. There were no statistically significant differences in the length of intensive care unit stay, the incidence of complications, and mortality 30 days after surgery.ConclusionIn total arch replacement (Sun's surgery), collecting and retransfusing aPRP reduced intraoperative transfusions of erythrocyte, plasma, and cryoprecipitate and decreased the duration of postoperative mechanical ventilation and hospitalization. This technique had no significant effect on the incidence of complications and mortality 30 days postoperatively.Copyright © 2019 Elsevier Inc. All rights reserved.

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