Platelet transfusions and patient outcomes after cardiac surgery

Abstract

Platelet transfusions are used to provide hemostatic capacity to patients with decreased number or functionality of platelets. The aim of this thesis was to expand knowledge about the safety and efficacy of platelet transfusions in general and in particular in cardiac surgery patients. In this thesis we found that cardiac surgery patients receiving an platelet transfusion shortly after cardiopulmonary bypass experienced less blood loss than patients who did not receive an early platelet transfusion. However, early platelet transfusion was not associated with more reinterventions, thromboembolic complications, infections, multi-organ failure, or mortality. Furthermore, we discovered that PAS-C as storage medium for platelets is associated with more favorable outcomes than plasma with regard to transfusions reactions, but not with regard to in vitro hemostatic measurements. Furthermore, we observed that fresh platelet concentrates are associated with more favorable outcomes than older platelet concentrates: less transfusions reactions in the whole transfused population, better hemostatic measurements in vitro, and less blood loss and mortality in cardiac surgery patients.</p