The Effect Of Autologous Platelet-rich Plasma Collection And Reinfusion On Renal Function In Patients With Major Vascular Surgery

Objective: Autologous platelet-rich plasma(aPRP)collection and retransfusion is a clinical technique that has been developed in recent years.Theoretically,aPRP collection and retransfusion can reduce platelet and coagulation in operation.Factors and physical contact with the Cardiopulmonary bypass(CPB)pipeline are disrupted,allogeneic transfusions are reduced,platelet counts and functions are protected,perioperative bleeding is reduced,and blood resources are saved.At present,there is controversy about the role of aPRP in organ protection,and there are relatively few clinical studies on the effect of aPRP on renal function in patients with aortic dissection surgery.The purpose of this was to observed whether the application of aPRP acquisition and reinfusion technology have influence on renal function in aortic dissection surgery and to discuss its application value in kidney protection.Methods: A total of 47 patients with aortic dissection surgery at Tianjin Chest Hospital from July 2015 to September 2017 were retrospectively analyzed.According to whether the aPRP collection and reinfusion technique was used during surgery,they were divided into two groups: control group(group A),who did not receive autologous platelet-rich plasma(group C)during the operation;and experimental group,who received autologous platelet-rich plasma(aPRP group)during the operation.All patients recorded complete clinical data.Observed index:(1)Preoperative general information: Gender,age,weight,and comorbidity.(2)Intraoperative CPB time,aortic cross-clamping time,and circulatory arrest time;record MAP and Hb at before induction of anesthesia(T1),before initiation of CPB(T2),before termination of CPB(T3),and before surgery(T4)(3)The intraoperative blood product(plasma,erythrocytes,cryoprecipitates and platelets)infusion volume,aPRP volume and postoperative chest drainage volume at 48 hours were recorded.(4)Changes in renal function parameters(urine output,sCr,BUN)during perioperative period(before and 1,3 and 7d after surgery);The incidence of renal replacement therapy(RRT)and the incidence of AKI were different between groups.(5)Postoperative mechanical ventilation time,ICU stay,hospital stay,and in-hospital mortality.Results: There were no statistically significant difference in renal function indexes(urine volume,sCr,BUN)between the two groups(P>0.05).There was no significant difference in the incidence of postoperative AKI and RRT between the two groups(P>0.05).The plasma infusion volume in aPRP group was significantly fewer than that in group A(P<0.001).There was no significant difference in the use of other blood products(erythrocytes,cryoprecipitates,and platelets)between the two groups during the operation(P>0.05).Conclusion: The use of aPRP collection and reinfusion in aortic dissection surgery had no significant effect on postoperative renal function;aPRP acquisition and reinfusion can reduce intraoperative plasma transfusion volume and save blood resources.