Effect of different autologous platelet separation techniques on perioperative outcome in patients undergoing major cardiovascular surgery: a retrospective cohort study.

OBJECTIVE: To compare two autologous platelet separation techniques with traditional autologous blood transfusion, focusing on their effects on coagulation function and postoperative recovery, in patients undergoing major cardiovascular surgery. METHODS: This retrospective study analyzed clinical data from 220 patients who underwent aortic replacement surgery or valve replacement surgery at Hunan Provincial People's Hospital between January 2019 and December 2022. The patients were divided into three group based on their intraoperative blood management protocols: Group A (n=48, red blood cells (RBCs) + platelet-rich plasma (PRP)), Group B (n=92, RBCs + platelets (PLT) + plasma), and Group C (n=80, autologous blood). Preoperative and postoperative findings were compared among the groups, including coagulation function, liver and kidney function, aortic cross-clamp time, cardiopulmonary bypass (CPB) time, blood product transfusion volume, length of intensive care unit (ICU) stay, duration of mechanical ventilation, and total drainage volume. RESULTS: Groups A and B showed decreased postoperative D-dimer level, reduced prothrombin time (PT) and activated partial thromboplastin time (APTT), and increased PLT (P<0.001), as well as lower volume of allogeneic blood transfusion (P<0.001) compared to Group C. The length of ICU stay (P=0.012) was shorter and total drainage volume (P=0.003) was less in Group A than Group C. Group A showed significantly lower postoperative urea nitrogen and creatinine levels than Group C (P<0.05), with no significant difference between Groups A and B (P>0.05). CONCLUSION: Autologous platelet separation enhances recovery by improving coagulation and reducing transfusions, with RBCs plus PRP scheme (Group A) best preserving liver and kidney function.