Does Plasma Sequestration Reduce Post-Operative Bleeding?

Hematologic profiles, postoperative blood loss and transfusion requirements were studied in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) in order to determine the effect of sequestration and reinfusion of platelet-rich plasma (PRP). Eighteen patients were randomly selected to have approximately one unit of PRP collected or not prior to CPB. Autologous PRP was reinfused in nine patients after reversal of anticoagulation. Evaluation of results was based upon thrombocyte counts, Hgb, Hct, and platelet index readings pre- and post-PRP reinfusion, amount of blood loss and volumes of homologous blood and banked blood products required postoperatively. There were no hemodynamic complications related to the sequestration process. PRP reinfused patients had significantly higher thrombocyte counts after reversal of anticoagulation (p < 0.05). Patients receiving PRP required approximately 2/3 less banked blood products, their bleeding being significantly reduced 24 hours postoperatively (p < 0.05). We concluded that plasma sequestration and reinfusion of autologous PRP post-bypass may serve as an effective and safe way in decreasing blood loss after cardiac operations necessitating extracorporeal circulation.