Platelet-rich-plasmapheresis for minimising peri-operative allogeneic blood transfusion

Carless, Paul A; Rubens, Fraser D.; Anthony, Danielle; O’Connell, Dianne; Henry, David

doi:10.1002/14651858.cd004172

Cited by 11 publications

(15 citation statements)

References 50 publications

(25 reference statements)

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“…Various studies support the use of PRP as an adjunct to hemostasis. 22 The interest of PRP glue application is to accelerate the healing cascade via the action of growth factors released in the application site and thus to reduce the risk of hematoma. 23,24 …”

Section: Discussionmentioning

confidence: 99%

Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study

Hersant

SidAhmed-Mezi

Padula

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:Seroma and hematoma formations are the most common complications after plastic surgery. The aim of this study was to assess the efficacy of autologous platelet-rich plasma (A-PRP) glue to reduce postoperative wound complications and improve surgical outcomes.Methods:Fifty-four patients were included in this study. They underwent breast reduction surgery, abdominoplasty, or limb lifting with A-PRP glue application on the entire surface of the subcutaneous tissue at the time of suture. Retrospective data were used for the control group. The primary endpoint was the incidence of postoperative seroma or hematoma. The secondary endpoint was the Patient and Observer Scar Assessment Scale score.Results:Demographics and clinical characteristics were not statistically different between the A-PRP glue group and the control group regarding age, sex ratio, and body mass index. After abdominoplasty, 37.5% of patients (3/8) in the control group experienced seroma and hematoma complications versus 12.5% of patients (2/16) in the A-PRP glue group (P = 0.55 and P = 0.25, respectively). After limb lifting, 50% of patients experienced postoperative complications in the control group versus no patient in the A-PRP glue group (P = 0.03*; * indicates that the P value is significant). After breast reduction, no patient experienced complication in the A-PRP glue group versus 25% of patients in the control group who experienced hematoma (P = 0.04*). The scar quality assessed 12 months after surgery showed no statistical differences between the groups.Conclusions:A-PRP glue seems effective to prevent seroma formation after limb lifting and hematoma formation after breast reduction. Wound-healing quality did not seem to be improved.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study

Hersant

SidAhmed-Mezi

Padula

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…The estimated PLT yield and product volume for plateletpheresis using the Trima device was compared to previously reviewed reports of intraoperative plateletpheresis and sequestration . An analysis of previous reports15‐19 is illustrated in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Patient data were entered into the apheresis device software to predict yield and procedure duration and targeting a minimum PLT yield of at least 3.0 × 10 11 in less than 60 minutes. This target yield represents the minimum quantity of PLTs in a standard plateletpheresis unit . The software allows collection of up to 15% of the calculated circulating volume, and available options were prioritized by targeting the maximum PLT yield within a 60‐minute procedure time.…”

Section: Methodsmentioning

confidence: 99%

“…In compliance with AABB standards, autologous PLTs were maintained between 20 and 24°C and reinfused within 4 hours; during CPB, the ambient room temperature was within this range. Autologous PLT units harvested during initial procedures were maintained for the duration of CPB on a flat resting surface covered in sterile towels.…”

Section: Methodsmentioning

confidence: 99%

“…Blood conservation strategies aim to reduce the reliance on allogeneic blood and its associated complications . As a component of a multimodal blood conservation program, PLT collection was recently included in the 2011 guidelines and given a Class IIa recommendation with Class A evidence . However, a Class III recommendation was suggested because of the significant risk of technical error, as was reserving PLT sequestration for patients with higher risk of allogeneic PLT transfusion in whom an adequate PLT yield could be reliably obtained.…”

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confidence: 99%

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Reduced use of allogeneic platelets through high‐yield perioperative autologous plateletpheresis and reinfusion

et al. 2013

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Desmopressin use for minimising perioperative allogeneic blood transfusion

Desborough

Estcourt

Dorée

et al. 2004

Cochrane Database of Systematic Reviews

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Background Public concerns regarding the safety of blood have prompted reconsideration of the use of allogeneic blood (blood from an unrelated donor) transfusion and a range of techniques designed to minimise transfusion requirements. Objectives To examine the efficacy of desmopressin acetate (1-deamino-8-D-arginine-vasopressin) in reducing peri-operative blood loss and the need for red blood cell (RBC) transfusion in patients who do not have congenital bleeding disorders. Search methods We identified studies by searching CENTRAL (The Cochrane Library 2008, Issue 1), MEDLINE (1950 to 2008), EMBASE (1980 to 2008), the Internet (to May 2008), and bibliographies of published articles. Selection criteria Controlled parallel-group trials in which adult patients scheduled for non-urgent surgery were randomised to desmopressin (DDAVP) or to a control group that did not receive DDAVP treatment. Trials were eligible for inclusion if they reported data on the number of patients exposed to allogeneic red cell transfusion or the volume of blood transfused. Data collection and analysis Primary outcomes were: the number of patients exposed to allogeneic red blood cell (RBC) transfusion, and the amount of blood transfused. Other outcomes measured were: blood loss, re-operation for bleeding, post-operative complications (thrombosis, myocardial infarction, stroke), mortality, and length of hospital stay. Treatment effects were pooled using a random-effects model. Main results Nineteen trials that included a total of 1387 patients reported data on the number of patients exposed to allogeneic RBC transfusion. DDAVP did not significantly reduce the risk of exposure to allogeneic RBC transfusion (relative risk (RR) 0.96, 95% confidence interval (CI) 0.87 to 1.06). However, the use of DDAVP significantly reduced total blood loss (weighted mean difference (WMD) −241.78 ml, 95% CI −387.55 to −96.01 ml). Although DDAVP appeared to reduce the overall volume of allogeneic blood transfused during the peri-operative period the result would not be considered clinically significant (WMD −0.3 units, 95% CI −0.60 to −0.01 units). Risk of re-operation due to bleeding was not reduced (RR 0.69, 95% CI 0.26 to 1.83). DDAVP treatment was not associated with an increased risk of death or myocardial infarction (RR 1.72, 95% CI 0.68 to 4.33; RR 1.38, 95% CI 0.77 to 2.50, respectively). Authors’ conclusions There is no convincing evidence that desmopressin (DDAVP) minimises peri-operative allogeneic RBC transfusion in patients who do not have congenital bleeding disorders. Although the data suggest that there is some benefit of using DDAVP as a means of reducing peri-operative blood loss the observed reductions were small and generally not clinically important. Based on the currently available evidence, the use of DDAVP to reduce peri-operative blood loss or allogeneic RBC transfusion cannot be supported.

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Platelet-rich-plasmapheresis for minimising peri-operative allogeneic blood transfusion

Cited by 11 publications

References 50 publications

Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study

Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study

Reduced use of allogeneic platelets through high‐yield perioperative autologous plateletpheresis and reinfusion

Desmopressin use for minimising perioperative allogeneic blood transfusion

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