Interventional cardiology

Platelet transfusion safe in cardiac surgery

Platelet transfusion is not associated with an increased risk of mortality, infection or thromboembolic events after heart surgery, Australian research concludes.

Writing in the journal Transfusion the researchers from the haematology department at St Vincent’s Melbourne say a lack of consistency in the guidelines, together with low quality evidence from studies, has led to significant variability in transfusion practice for patients having coronary artery bypass surgery.

“There are [also] conflicting reports on the effects of platelet transfusion and patient outcomes, with some studies suggesting an association with mortality and others reporting no associations.

The retrospective cohort study involved 5233 patients undergoing heart surgery, of whom 553 (10.15%) received intraoperative platelet transfusions.

Patients receiving platelets tended to be older, have a higher BMI and lower rates of diabetes and dyslipidemia.

Results showed that after adjusting for confounders, platelet transfusion was not associated with increased risk of 30 day mortality or infective complications.

However, platelet transfusion was associated with an almost three-fold increased risk of returning to theatre for bleeding (RR 2.46).

Transfusion was also linked to  a decreased risk of thromboembolic events (RR 0.28) and cerebrovascular accidents (CVA) (RR 0.24).

“This may be a chance finding, as the total number of CVA events in both groups was small, and we performed multiple comparisons,” the authors said.  

“Future prospective studies are warranted to define which patients are most likely to benefit from platelet transfusion,” they concluded.

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