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Assessing transfusion need in patients with type A aortic dissection with multiplate aggregometry.
Biniam Melese Bekele1,2, Sascha Ott2,3,4, Benjamin O'Brien2,3,4
1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Berlin, Germany.
Plos One
|July 17, 2025
Summary
Preoperative platelet function testing using Multiplate® aggregometry can predict transfusion needs in patients undergoing emergency surgery for acute type A aortic dissection (ATAAD). This helps optimize treatment strategies for these high-risk patients.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Anesthesiology
Background:
- Acute type A aortic dissection (ATAAD) is a critical surgical emergency with high mortality.
- Preoperative platelet dysfunction, often exacerbated by antiplatelet drugs, increases surgical risks.
- Evaluating platelet function preoperatively is crucial for managing ATAAD patients.
Purpose of the Study:
- To investigate the association between preoperative platelet function, assessed by Multiplate® aggregometry, and transfusion requirements in ATAAD patients.
- To determine if Multiplate® testing can guide transfusion strategies in this population.
Main Methods:
- An observational retrospective study of 180 patients undergoing emergency ATAAD repair.
- Preoperative platelet function assessed using Multiplate® analyzer (ADP, ASPI, and TRAP tests).
- Primary outcome: number of blood products transfused; secondary outcomes: re-exploration, hospital stay, 30-day mortality.
Main Results:
- Abnormal platelet aggregation was common (ASPI: 49.2%, ADP: 26%, TRAP: 63.5%).
- Patients with abnormal ADP test responses required significantly more intraoperative red blood cells and platelet concentrates.
- No significant differences were found in re-exploration rates, hospital stay, or 30-day mortality.
Conclusions:
- Multiplate® aggregometry is a valuable tool for assessing platelet dysfunction in ATAAD patients.
- Preoperative platelet function testing can help predict and manage transfusion needs.
- This aids in optimizing treatment strategies for ATAAD surgical repair.
