Abstract
Objectives: Fibrin sealants are popular for the improvement of perioperative hemostasis and reducing
blood transfusion needs. Biological glues prepared from pooled human donor plasma
have an inherent risk of transmission of blood-borne disease and are quite expensive
to use. A system for the production of autologous fibrin sealant reenforced by platelets
has been developed. Its efficacy, safety and economic benefits have been evaluated
in a prospective, randomized study. Material: 20 consecutive patients undergoing replacement of the ascending aorta by the same
surgical team had local application of either Tissucol™ (Group A) or autologous fibrin
glue (Group B) for hemostasis. Results: No adverse effects of either glue were recorded. The volume of produced autologous
fibrin glue was 25 cc PRP. Platelet yield was 72 %. The two groups were comparable.
Efficacy was group comparable. Average cost for sealants in Group A was 470 ± 100
Euros compared to 273 Euros in Group B, p = 0.004. Conclusions: Autologous fibrin glue reenforced by autologous platelets can be safely produced
in the operating room in a large volume, with an comparable efficacy at a lower cost
than commercial sealants.
Key words
Surgery of ascending aorta - surgical glue - hemostasis - hemorrhage - costs
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1 Presented at 4th joint meeting of the German, Austrian and Swiss Societies for Thoracic
and Cardiovascular Surgery, February 15 - 18, 2004, Hamburg, Germany
Dr. M. D., FETCS J. T. Christenson
Clinic for Cardiovascular Surgery, University Hospital
24 rue Micheli-du-Crest
1211 Geneva 14
Switzerland
Phone: + 41223727872
Fax: + 41 2 23 72 76 34
Email: jan.christenson@hcuge.ch