The hemostatic effect of transfusing fresh whole blood versus platelet concentrates after cardiac operations

A trial of fresh autologous whole blood to treat dilutional coagulopathy following cardiopulmonary bypass in infants

“…Studies in adults also found that fresh homologous whole blood improves platelet function and reduces transfusion requirements more effectively than platelet concentrate (12,13). The use of fresh autologous blood is advantageous in that it is readily available, whereas very fresh homologous whole blood can be difficult to obtain from a blood bank.…”

Anemia‐induced increase in the bleeding time:implications for treatment of nonsurgical blood loss

“…Ho et al 17 reported significant decreases in the activated partial thromboplastin time and BT after RBC transfusions to patients with anemia. Mohr et al 18 reported a significant decrease in BT after the administration to patients of allogeneic fresh whole blood, as compared to the BTs with allogeneic liquid-preserved platelets after CPB surgery. They concluded that the hemostatic effect of 1 unit of allogeneic, fresh, whole blood after CPB surgery was at least equal, if not superior, to the hemostatic effect of 10 units of allogeneic pooled platelets stored at 22°C for as long as 3 days in reducing the BT measurement.…”

A randomized trial of perioperative hemodilution versus transfusion of preoperatively deposited autologous blood in elective surgery

“…Of particular interest may be a recent observation that fresh whole blood rapidly restores platelet function after cardiac bypass surgery. 16 Hemodilution protocols may provide a simple way to provide fresh whole blood without the loss of platelet function that occurs after storage at 4°C.…”

“…Unfortunately, most of these studies were uncontrolled or used historical controls for their comparisons. For example, a recent study on hemodilution4 in liver resec-tion claimed that homologous blood was needed for only 3 of 22 patients who underwent hemodilution, as compared to 16 of 22 historical controls. Because improved surgical technique, case selection factors, a physician's reluctance to transfuse blood because of increased awareness of risks, or the use of other methods, such as intraoperative autologous transfusion, to avoid the use of homologous blood could have accounted for these differences, however, the value of hemodilution is difficult to ascertain.…”