PLATELET-LEUKOCYTE PLASMAPHERESIS ATTENUATES THE DELETERIOUS EFFECTS OF CARDIOPULMONARY BYPASS

A method of harvesting a high yield of concentrated platelet- and leukocyte-rich plasma was developed with the goal of attenuating some of the deleterious effects of cardiopulmonary bypass. The study involved 32 patients who underwent coronary artery bypass grafting with plasmapheresis before cardiopulmonary bypass and a control group of 32 patients who did not have plasmapheresis. A volume of 857 +/- 359 mL of platelet- and leukocyte-rich plasma was concentrated from 4.6 +/- 1.5 L of blood, and red cells and plasma were returned to the patient. The platelet- and leukocyte-rich plasma contained yields of 3.5 +/- 1.4 x 10(11) platelets and 3.4 +/- 1.9 x 10(9) leukocytes. There were no differences in age, sex, duration of cardiopulmonary bypass, and major risk factors between groups. However, total mediastinal chest tube drainage was 788 +/- 542 mL in the controls and 425 +/- 207 mL in the plasmapheresis group (p < 0.01). Homologous units transfused were 3.9 +/- 2 in controls and 1.6 +/- 2 in the plasmapheresis group (p < 0.01). Arterial oxygen tension on extubation was 94 +/- 32 mm Hg in controls and 119 +/- 25 mm Hg in the plasmapheresis group (p < 0.01). This technique of platelet and leukocyte protection results in reduced post-operative bleeding, a decreased need for homologous blood products, and improved pulmonary function.