title: Platelet function in stored heparinised autologous blood is not superior to in patient platelet function during routine cardiopulmonary bypass.
abstract: BACKGROUND
  In cardiac surgery, cardiopulmonary bypass (CPB) and unfractionated heparin have negative effects on blood platelet function. In acute normovolemic haemodilution autologous unfractionated heparinised blood is stored ex-vivo and retransfused at the end of the procedure to reduce (allogeneic) transfusion requirements. In this observational study we assessed whether platelet function is better preserved in ex vivo stored autologous blood compared to platelet function in the patient during CPB.
  
  
  RESULTS
  We measured platelet aggregation responses pre-CPB, 5 min after the start of CPB, at the end of CPB, and after unfractionated heparin reversal, using multiple electrode aggregometry (Multiplate®) with adenosine diphosphate (ADP), thrombin receptor activating peptide (TRAP) and ristocetin activated test cells. We compared blood samples taken from the patient with samples taken from 100 ml ex-vivo stored blood, which we took to mimick blood storage during normovolemic haemodilution. Platelet function declined both in ex-vivo stored blood as well as in blood taken from the patient. At the end of CPB there were no differences in platelet aggregation responses between samples from the ex vivo stored blood and the patient.
  
  
  CONCLUSIONS
  Ex vivo preservation of autologous blood in unfractionated heparin does not seem to be profitable to preserve platelet function.
authors.affiliation: Department of Anesthesiology, University of Groningen, University Medical Center Groningen, The Netherlands. r.c.g.huet@anest.umcg.nl
authors.forename: Rolf C G
authors.initials: RC
authors.lastname: Gallandat Huet
authors.forename: Adrianus J
authors.initials: AJ
authors.lastname: de Vries
authors.forename: Vladimir
authors.initials: V
authors.lastname: Cernak
authors.forename: Ton
authors.initials: T
authors.lastname: Lisman
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology*; D001792:Blood Platelets / Q000378:metabolism*; D001793:Blood Preservation; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass; D005260:Female; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests
chemical_list: D000925:Anticoagulants; D006493:Heparin