The Intraoperative Use of Plateletpheresis: A Review

T HE FEAR of blood transmissible disease has led to various alternative blood conservation techniques that minimize blood loss and exposure to blood products. Preoperative autologous blood withdrawal has been widely practiced for elective orthopedic procedures. 1 However, this requires a lot of preparation and frequent patient visits to the blood bank center. In addition, blood is wasted when the autologous blood is not reinfused into the patient and cannot be used for another patient. This technique is also unsuitable for most cardiac patients, patients with anemia, and patients with other critical disease. The autotransfusion unit is a popular device used for intraoperative blood salvage. Pharmacologic agents such as desmopressin, tranexamic acid, epsilon-aminocaproic acid, and aprotinin have been widely used in cardiac surgery to produce hemostasis and minimize blood loss and usage. Recently, acute plateletpheresis (APP) has been reintroduced, mainly in cardiac surgery. This discussion will briefly describe the method used for intraoperative APP and the merits of the intraoperative use of this technique.