1.
Efficacy of platelet-rich plasma combined with allograft bone in the management of displaced intra-articular calcaneal fractures: a prospective cohort study
Wei LC, Lei GH, Sheng PY, Gao SG, Xu M, Jiang W, Song Y, Luo W
Journal of Orthopaedic Research. 2012;30((10):):1570-6.
Abstract
To investigate whether platelet-rich plasma (PRP) when used with allograft bone improves the management outcome of displaced intra-articular calcaneal fractures. Over a 7-year period, all displaced type III calcaneal fractures admitted in our department (276 fractures in 254 patients) were randomly divided into three groups according to the plan of management: autograft alone (n = 101), allograft combined with PRP (n = 85), or allograft alone (n = 90). Radiographic imaging and three-dimensional computed tomography were used to assess the thalamic portion, Bohler's angle, the crucial angle of Gissane, and the height, width and length of the calcaneum. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind-foot scoring system was used to evaluate the hind foot function at 12, 24, and 72 months postsurgery. At 12 months no significant difference existed in outcome amongst the treatment groups (p > 0.05). However, at 24 and 72 months the results of the autograft, and the allograft combined with PRP, were similar and both were significantly better than that of the allograft alone (p < 0.05). PRP augmented the favorable outcome of allografts in the management of displaced calcaneal fractures, and matched that of autograft used alone. The findings of this study thus support the clinical use of PRP in conjunction with allograft in the treatment of displaced intra-articular calcaneal fractures. Copyright 2012 Orthopaedic Research Society.
2.
Effects of blood washing and autotransfusion during cardiopulmonary bypass on erythrocyte immune and kidney function
Song Y, Li R, Gu XH, Gong XJ, Zhang G, Wu SM, Zhang XQ, Li SX
Zhonghua Yi Xue Za Zhi. 2006;86((32):):2293-6.
Abstract
OBJECTIVE To study changes of erythrocyte immune and kidney function after autotransfusion washed red blood cells during cardiopulmonary bypass (CPB). METHODS Thirty-two patients undergoing valve replacement with CPB were randomly divided into study group and control group (16 in each group). In study group, the blood in operative field and the residual blood in the extracorporal machine were collected, centrifuged, washed and retransfused to patients. Patients in control group were transfused with the residual blood in the extracorporal machine without any disposal or banked blood. All patients were used with membrane oxygenator. Before CPB, 12 h, 24 h, 72 h and 7 d after CPB, whole blood were taken, then the erythrocyte immune function (C3bRR, RICR) and level of plasma free hemoglobin (FHB) were assayed, and post-operation renal function was compared between the two groups. Moreover, total volume of banked blood transfused to patients after CPB was recorded. RESULTS (1) After 12 hours, 24 hours, 72 hours, 7 days of CPB, the RBC-C3bRR (14. 3% +/- 4. 7%, 15. 9% +/- 3. 6%, 16. 6% +/- 2. 8%, 19. 9% +/- 4. 1%) and RBC-ICR (8. 7% +/- 1. 9%, 9. 2% +/- 2. 0%, 9. 5% +/- 2. 6%, 12. 0% +/- 2. 0%) in study group were significantly elevated than that in control group (RBC-C3bRR 10. 7% +/- 2. 4%, 11. 3% +/- 3. 0%, 12. 3% +/- 3. 5%, 14. 5% +/- 2. 0%, RBC-ICR 5. 9% +/- 1. 4%, 6. 0% +/- 1. 8%, 7. 0% +/- 1. 7%, 8. 7% +/- 2. 7%). The erythrocyte immune function after CPB was better and restored faster in study group than that in control group (P < 0. 05 in all). (2) After 12 hours, 24 hours of CPB, the levels of FHB (0. 41 g/L +/- 0. 13 g/L, 0. 03 g/L +/- 0. 02 g/L) in study group were significantly lower than that in control group (1. 02 g/L +/- 0. 23 g/L, 0. 54 g/L +/- 0. 09 g/L) (P < 0. 01). After 24 hours of CPB, the level of urinary protein excretion (0. 19 g/d +/- 0. 08 g/d) in study group was significantly lower than that in control group (0. 32 g/d +/- 0. 07 g/d) (P < 0. 05). (3) After 24 hours of CPB, the level of 24 h creatinine clearance was significantly elevated in study group (68 ml x min(-1) x 1. 73 m(-2) +/- 10 ml x min(-1) x 1. 73 m(-2)) than that in control group (45 ml x min(-1) x 1. 73 m(-2) +/- 4 ml x min(-1) x 1. 73 m(-2)) (P < 0. 01). (4) The total volume of banked RBCs transfused after CPB were fewer in study group (2. 0 U +/- 1. 1 U) than that in control group (7. 4 U +/- 2. 3 U) (P < 0. 01). CONCLUSION Autotransfusion of washed red blood cells during CPB may improve significantly the erythrocyte immune function and protect kidney function better than transfusion of residual blood in the extracorporal machine or banked blood.