Novel autologous, high concentrated fibrin as advanced hemostatic agent for coronary surgery.


Journal

Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis
ISSN: 1473-0502
Titre abrégé: Transfus Apher Sci
Pays: England
ID NLM: 101095653

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 16 02 2021
revised: 09 05 2021
accepted: 21 05 2021
pubmed: 9 6 2021
medline: 13 1 2022
entrez: 8 6 2021
Statut: ppublish

Résumé

Variability in transfusion outcomes and excessive postoperative bleeding represents a significant problem in cardiac surgery. The effort to reduce bleeding complications and transfusion outcomes is desirable. Our study investigated the feasibility of reducing bleeding complications and transfusion requirements by applying perioperatively prepared autologous bio-regenerative fibrin sealant. A prospective, case-control study enrolled 74 patients undergoing coronary artery bypass grafting by a single surgeon. Patients in the control group (N = 43), received traditional methods of hemostasis, while patients in the experimental group (N = 31) were treated additionally with autologous bio-regenerative fibrin. Patients were well-matched with regard to basic demographic, laboratory and procedural data. Allogeneic blood transfusion requirement in control group was 39.5 % (17 of 43 patients), compared to 6.5 % (2 of 31 patients) in treated group (p < 0,001). The lower infection rate in the experimental group was also noted. No safety issues were identified during the preparation and application process. Autologous bio-regenerative fibrin can be safely prepared, with no time consuming, and was demonstrated to be a useful tool to decrease allogeneic blood transfusion requirements following elective coronary artery bypass grafting surgery. A prospective randomized trial is needed to confirm these findings.

Sections du résumé

BACKGROUND BACKGROUND
Variability in transfusion outcomes and excessive postoperative bleeding represents a significant problem in cardiac surgery. The effort to reduce bleeding complications and transfusion outcomes is desirable. Our study investigated the feasibility of reducing bleeding complications and transfusion requirements by applying perioperatively prepared autologous bio-regenerative fibrin sealant.
METHODS METHODS
A prospective, case-control study enrolled 74 patients undergoing coronary artery bypass grafting by a single surgeon. Patients in the control group (N = 43), received traditional methods of hemostasis, while patients in the experimental group (N = 31) were treated additionally with autologous bio-regenerative fibrin.
RESULTS RESULTS
Patients were well-matched with regard to basic demographic, laboratory and procedural data. Allogeneic blood transfusion requirement in control group was 39.5 % (17 of 43 patients), compared to 6.5 % (2 of 31 patients) in treated group (p < 0,001). The lower infection rate in the experimental group was also noted. No safety issues were identified during the preparation and application process.
CONCLUSION CONCLUSIONS
Autologous bio-regenerative fibrin can be safely prepared, with no time consuming, and was demonstrated to be a useful tool to decrease allogeneic blood transfusion requirements following elective coronary artery bypass grafting surgery. A prospective randomized trial is needed to confirm these findings.

Identifiants

pubmed: 34099403
pii: S1473-0502(21)00137-3
doi: 10.1016/j.transci.2021.103171
pii:
doi:

Substances chimiques

Hemostatics 0
Fibrin 9001-31-4

Types de publication

Clinical Trial Journal Article

Langues

eng

Pagination

103171

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Slobodan Micovic (S)

Cardiovascular Institute Dedinje, Milana Tepića 1, 11000, Belgrade, Serbia. Electronic address: renovaresearch16@gmail.com.

Peter Everts (P)

Gulf Coasts Biologics Inc, 4331 Veronica S Shoemaker Blvd, Fort Myers, FL, 33916, United States. Electronic address: everts@me.com.

Branko Calija (B)

Cardiovascular Institute Dedinje, Milana Tepića 1, 11000, Belgrade, Serbia. Electronic address: brankocal@yahoo.com.

Evgenija Strugarevic (E)

Cardiovascular Institute Dedinje, Milana Tepića 1, 11000, Belgrade, Serbia. Electronic address: evgenijastrugarevic@yahoo.com.

Nikola Grubor (N)

Clinical Centre of Serbia, Pasterova2, 11000, Belgrade, Serbia. Electronic address: n.grubor@yahoo.com.

Mladen Boricic (M)

Cardiovascular Institute Dedinje, Milana Tepića 1, 11000, Belgrade, Serbia. Electronic address: boricic.mladen@gmail.com.

Jelena Lesanovic (J)

Cardiovascular Institute Dedinje, Milana Tepića 1, 11000, Belgrade, Serbia. Electronic address: miss.sagic@gmail.com.

Henk Box (H)

St Catherine's Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands. Electronic address: box00000@planet.nl.

Dzihan Abazovic (D)

Emergency Medical Centre of Montenegro, Vaka Đurovića bb, 81110, Podgorica, Montenegro. Electronic address: adzihan@gmail.com.

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Classifications MeSH