title: [Intraoperative autologous based blood conservation strategies in mitral valve replacement].
abstract: OBJECTIVE
  To evaluate whether intraoperative autologous donation (IAD) can reduce perioperative blood transfusion for patients underwent mitral valve replacement (MVR).
  
  
  METHODS
  A total of 318 patients received implementation of IAD from January 2011 to December 2013 were analyzed retrospectively, and compared with 517 patients of the previous 36-month period (from January 2008 to December 2012). The method of small-volume retrograde autologous priming, strict blood transfusion standard along with IAD together constituted a progressive blood-saving strategy. Statistical methods including Students' t-test, Pearson's χ(2) test, Kruskal-Wallis analysis and multivariate Logistic regression model were used for comparisons of the data.
  
  
  RESULTS
  There were no significant difference between IAD group and non-IAD group considering preoperative patient demographics, characteristics and preoperative comorbidities. However, IAD group significantly reduced number of patients transfused with intra/post-operative packed red-blood cell (PRBC) (55(17.0%) vs. 215 (42.1%), χ(2)=53.0, P=0.000), and had significantly reduced postoperative chest tube output (150(380) ml vs. 700(660) ml, H=195.648, P=0.000), length of stay ((16±6) d vs. (20±8)d, t=9.60, P=0.000). But hematocrit were lower in IAD group (30%±5% vs.33%±4% at end of operation, t=7.76, P=0.000; 30%±4% vs. 32%±5% at discharge, P=0.000, t=3.86). Multivariate logistic aggression analysis revealed that age, IAD and smoking history were factors influencing the probability of intra or postoperative blood transfusion.
  
  
  CONCLUSIONS
  Implementation of blood conservation strategies based on intraoperative autologous donation in mitral valve replacement surgery can significantly reduce intra/postoperative blood transfusion as well as postoperative complications.
authors.affiliation: Department of Cardiothoracic Surgery, First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China.
authors.forename: Linfeng
authors.initials: L
authors.lastname: Qian
authors.forename: Junnan
authors.initials: J
authors.lastname: Zheng
authors.forename: Liangwei
authors.initials: L
authors.lastname: Chen
authors.forename: Jianjie
authors.initials: J
authors.lastname: Jiang
authors.forename: Yinglian
authors.initials: Y
authors.lastname: Chen
authors.forename: Liping
authors.initials: L
authors.lastname: Shi
authors.forename: Haige
authors.initials: H
authors.lastname: Zhao
authors.forename: Yiming
authors.initials: Y
authors.lastname: Ni
mesh_terms: D001804:Blood Transfusion, Autologous; D057668:Bloodless Medical and Surgical Procedures; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006400:Hematocrit; D006801:Humans; D016015:Logistic Models; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies