[Haptoglobin administration for hemolysis with autotransfusion of blood ultrafiltered after cardiopulmonary bypass].

Ultrafiltration is well known as a useful method of hemoconcentration of the blood after cardiopulmonary bypass, but free hemoglobin increase is a problem in autotransfusion. The purpose of this study was to investigate the effect of haptoglobin administration for hemolysis with autotransfused blood ultrafiltered after cardiopulmonary bypass. By means of haptoglobin administration, autotransfusion of blood ultrafiltered with Hemocon (CD Medical Inc.) composed cellulose acetate membrane was performed in patients over a long period (max 313 min) of cardiopulmonary bypass, and with high serum free hemoglobin levels (max 128 mg/dl) at the end of the cardiopulmonary bypass. Comparing the prophylactic administration with the therapeutic administration of haptoglobin, both methods effectively prevented the increment of serum free hemoglobin level, but prophylactic administration (priming administration) was safer and more useful considering free hemoglobin level in ultrafiltered blood and changes of serum free haptoglobin, free hemoglobin and creatinine clearance during and after the operation.