Thesis Fabienne van Hout

On 5 April 2023 Sanquin researcher Fabienne van Hout defended her PhD thesis Platelet transfusions and patient outcomes after cardiac surgery at Leiden University.

Promotores: Prof JG van der Bom MD PhD
Copromotor: JL Kerkhoffs MD PhD and M Palmen MD PhD
Venue: Academy Building, Leiden University

Summary

Platelet transfusions are used to provide hemostatic capacity to patients with decreased number or functionality of platelets. The aim of this thesis was to expand knowledge about the safety and efficacy of platelet transfusions in general and in particular in cardiac surgery patients. In this thesis we found that cardiac surgery patients receiving an platelet transfusion shortly after cardiopulmonary bypass experienced less blood loss than patients who did not receive an early platelet transfusion. However, early platelet transfusion was not associated with more reinterventions, thromboembolic complications, infections, multi-organ failure, or mortality. Furthermore, we discovered that PAS-C as storage medium for platelets is associated with more favorable outcomes than plasma with regard to transfusions reactions, but not with regard to in vitro hemostatic measurements. Furthermore, we observed that fresh platelet concentrates are associated with more favorable outcomes than older platelet concentrates: less transfusions reactions in the whole transfused population, better hemostatic measurements in vitro, and less blood loss and mortality in cardiac surgery patients.

Chapters

Chapter 1
General introduction and outline of this thesis

Part I Platelet transfusions in general


Chapter 2
Transfusion reactions after transfusion of platelets stored in PAS-B, PAS-C, or plasma: a nationwide comparison abstract

Chapter 3
Comparison of haemostatic function of PAS-C–platelets vs plasma–platelets in reconstituted whole blood using impedance aggregometry and thromboelastography abstract

Chapter 4
Effect of storage of platelet concentrates in PAS-B, PAS-C, or plasma on transfusion reactions abstract

Part II Platelet transfusions in cardiac surgery patients


Chapter 5
Does a platelet transfusion independently affect bleeding and adverse outcomes in cardiac surgery? abstract

Chapter 6
The association between storage time of platelet concentrates and clinical outcomes in cardiac surgery patients: an observational cohort study

Chapter 7 
General discussion

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Download PhD thesis (university repository)

Thesis Fabienne van Hout