Establishment of a new autologous normovolemic hemodilution method focused on the preservation of platelet function

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K18293
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Kyoto University
• Principal Investigator: Kawamoto Shuji 京都大学, 医学研究科, 助教 (80766668)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 希釈式自己血輸血 / 血小板 / 血小板機能 / ポリオレフィン / 低温保存 / 血小板保存病変

Outline of Final Research Achievements

We investigated storage bags and storage temperatures that better preserve platelet function during dilute autologous normovolemic hemodilution (ANH), which is recommended in surgeries with massive bleeding risk.(1) Polyolefin bags maintained more than twice the ADP-induced platelet aggregation rate and significantly suppressed P-selectin expression, a platelet activation marker, compared to polyvinyl chloride bags. These results suggest that ANH using polyolefin bags is advantageous in improving hemostatic function compared to the conventional method.(2) Six-hour cold storage showed higher platelet aggregability than room temperature storage and suppressed the elevation of platelet storage lesion markers. Cold storage may improve the storage environment for platelets compared to room temperature storage and may contribute to improved hemostatic performance.

Free Research Field

麻酔科学　集中治療医学　血栓止血血管学

Academic Significance and Societal Importance of the Research Achievements

希釈式自己血輸血法は、安全、簡便かつ安価に施行でき、新鮮な血小板・凝固因子が豊富に含まれ、止血効果が高い。しかし、従来の希釈式自己血輸血法は、その採血方法、保存方法において寿命の短い血小板機能の維持に関しては考慮されていない。本研究では保存バッグや保存温度を改変することで、血小板機能を温存し最大限止血効果を発揮できる新たな希釈式自己血輸血法を開発した。我々が開発した新手法は、手術中の出血量の減少や、周術期の輸血量減少につながる可能性があり、学術的意義が大きい。周術期の輸血製剤使用量軽減は、昨今不足している貴重な輸血製剤の有効利用という面から考えても極めて社会的意義が大きいと考えられる。