The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 519-523, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
The effect on blood coagulation of the exclusive use of transfusions of frozen red cells during and after cardiopulmonary bypass
J Umlas and R Sakhuja
The essentially indefinite storage life of previously frozen erythrocytes
(PFE), combined with the virtual freedom from hepatitis, high
2,3-diphosphoglycerate (2,3-DPG) content, and low level of HL-A antigens,
should make its use in open-heart surgery attractive. However, since the
suspension medium for PFE is usually saline, the potential exists for
creating a hemorrhagic diathesis by accentuating the dilution of plasma
procoagulants by the pump prime. To test this possibility, we used PFE
exclusively in transfusing a group of 13 open- heart surgery patients; they
were given no plasma or platelets. A control group of 12 open-heart surgery
patients were transfused with only shelf blood. Determination of
prothrombin times (PT), partial thromboplastin times (PTT), platelets, and
fibrinogen were done at various intervals. No clinically significant
differences between the two groups were seen in any of these parameters at
any interval, and there was no significant difference between the groups in
amount of chest tube drainage or transfusions in the first 24 hours. It is
concluded that most open-heart surgery can be safely performed exclusively
with frozen blood.