Effects of Recombinant Human Thrombopoietin on Severe Thrombocytopenia in Patients With Acute Type A Aortic Dissection

Background: Postoperative thrombocytopenia in patients with acute type A aortic dissection (AAD) necessitates platelet transfusions and is associated with higher morbidity and mortality. Objective: This retrospective study aimed to evaluate the effects of recombinant human thrombopoietin (rhTPO) on AAD patients who experienced severe postoperative thrombocytopenia (platelet count nadir <20 × 109/L). Methods: We retrospectively evaluated 43 AAD patients who underwent open aortic repair surgery with subsequent severe thrombocytopenia at the Second Hospital of Shandong University between June 2019 and June 2022. We compared patient outcomes between rhTPO-treated patients (n = 20) with nontreated patients (n = 23). The primary outcome was to evaluate the association of the rhTPO treatment with postoperative platelet count response. The secondary outcomes included transfusions of blood components and length of hospital stay. Results: Compared with nontreated controls, significantly higher levels of platelet count were observed in rhTPO-treated patients on POD7 (110.1 ± 18.1 vs 83.6 ± 19.1 [×109/L]; P < 0.001). The time required for the platelet count to increase to >100 × 109/L was significantly less in rhTPO-treated patients compared with controls (6.8 ± 0.85 vs 8.5 ± 1.5 days; P < 0.001). The rhTPO treatment was significantly correlated with the reductions in perioperative plasma transfusion (1435 ± 114 vs 1743 ± 206 mL; P < 0.001) and days of hospital stay ( P = 0.003). Conclusions and relevance: We concluded that rhTPO treatment was significantly associated with increased platelet count recovery in postcardiac surgery AAD patients suffering from severe thrombocytopenia. Besides, the rhTPO therapy appeared to be correlated with reduced blood transfusions and length of hospital stay.