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Related Experiment Videos

Platelet abnormalities associated with massive autotransfusion

E E Moore, E L Dunn, D J Breslich

    The Journal of Trauma
    |December 1, 1980
    PubMed
    Summary
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    Large-volume autotransfusion impairs platelet function, leading to prolonged bleeding times. This platelet dysfunction persists 24 hours post-transfusion, even as other coagulation parameters normalize.

    Area of Science:

    • Transfusion Medicine
    • Hematology
    • Surgical Hemostasis

    Background:

    • Large-volume autotransfusion is a common practice.
    • Potential hemostatic defects associated with autotransfusion are known.
    • The specific impact on platelet function remains poorly understood.

    Purpose of the Study:

    • To investigate the effects of large-volume autotransfusion on platelet function in a canine model.
    • To assess changes in coagulation parameters and bleeding times following autotransfusion.
    • To evaluate the potential protective effect of methylprednisolone.

    Main Methods:

    • Twenty mongrel dogs underwent controlled intraperitoneal hemorrhage and reinfusion using the Sorenson System.
    • Animals received autotransfusion of twice their estimated blood volume (E.B.V.) over 4 hours with citrate phosphate dextrose (ACD) as anticoagulant.

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  • Platelet aggregation, coagulation tests (PT, PTT, TCT), fibrinogen levels, and bleeding times were measured. Methylprednisolone was administered to a subset of animals.

    • Main Results:

    • Autotransfusion induced a moderate consumptive coagulopathy, prolonging PT, PTT, and TCT, and decreasing fibrinogen.
    • Platelet counts significantly decreased to 71% of baseline.
    • Platelet aggregation response to ADP and collagen was markedly depressed, leading to prolonged bleeding times. These platelet defects persisted 24 hours post-transfusion.
    • Methylprednisolone did not significantly alter coagulation parameters.

    Conclusions:

    • Large-volume autotransfusion significantly impairs platelet function and prolongs bleeding times.
    • Platelet dysfunction persists beyond the immediate post-transfusion period.
    • The hemostatic defects observed are primarily related to platelet impairment rather than other coagulation factors.