Date of Award

5-2014

Document Type

Thesis

Degree Name

Master of Science (MS)

College/School

College of Science and Mathematics

Department/Program

Biology

Thesis Sponsor/Dissertation Chair/Project Chair

Sandra D. Adams

Committee Member

Lee H. Lee

Committee Member

Vladislav Snitsarev

Committee Member

Juan B. Grau

Abstract

Transfusion has been associated with increased morbidity and short- and longterm mortality after cardiac surgery. However, the physiological effects of transfusion in this setting are poorly described. This study aimed to examine the effects of transfusion on blood composition and characteristics after cardiac surgery.

1,134 patients underwent an isolated coronary artery bypass graft surgery with no post-operative complications. Of these, 407 (35.8%) patients received a transfusion. Propensity-matching was used to generate a balanced cohort of 636 patients. 26 variables from standard blood tests were retrospectively collected. A repeated measures analysis of variance test was used to examine how these variables changed over time and if the changes were affected by transfusion.

11 of the 26 variables were shown to be significantly affected by transfusion. Transfusion caused a relative increase in blood urea nitrogen, creatinine, red blood cells, hematocrit, mean corpuscular hemoglobin concentration, and platelets. Conversely, it was associated with a decrease in calcium, carbon dioxide, pH, pO2, white blood cell count, and mean corpuscular hemoglobin.

When examining associated clinical relevance of the significant (and nonsignificant) results, several trends begin to emerge. There was little evidence that transfusion cured anemia, at least by the traditional measure of hemoglobin, although the data suggests that it does increase the oxygen-carrying capacity of the blood. However, hepatic and renal function may be impaired by the administration of donor blood products.

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