[Preoperative plasmapheresis].

Abstract

Plasmapheresis is performed during the preoperative patient preparation phase of the Ulm Autologous Transfusion Concept (ATU). On an outpatient basis, weeks or months before the operation, 900 ml autologous plasma is donated per visit using the one needle technique, shock frozen, and stored at -30 degrees C or lower. During a period of approximately 1 1/4 years, 813 patients were studied in order to obtain information (in addition to the observation of the usual vital statistics) concerning the effect of plasmapheresis on homeostasis and coagulation factors directly before, directly after, 2 h after, and 24 h after (in-patients only). A complete electrolyte solution of the Ringer-lactate type was used as volume substitution (1000 ml or 1500 ml). Arterial blood pressure and heart rate showed no significant change. The transient decrease in various laboratory parameters was within tolerable limits. The parameters for blood protein, anti-thrombin III, and immunoglobulin G had already normalized within 24 h. Our more than three year experience with more than 2600 patients and the collective data indicate no reason not to perform plasmapheresis on non-fasting outpatient patients. The for the most part postoperatively transfused autologous fresh frozen plasma represents an ideal, long acting volume substitution which contains such blood components as antithrombin III, immunoglobulins, and factor XIII. These blood components could be a contributing factor for a decreased danger of thrombosis, embolie, and infection, as well as provide for better wound healing.