Background

Autologous blood transfusion (ABT), as a blood conservation strategy, is widely used in surgeries for acute Stanford-A aortic dissection(ATAAD). However, investigations into the correlation between ABT and postoperative 24-hour serum creatinine(Scr) are limited. This study evaluates the relationship between ABT and Scr in patients who underwent ATAAD surgery.

Methods

This retrospective study included 157 ATAAD patients from our center between February 2020 and November 2022. Patients were categorized into a death group(n = 12) and a survival group (n = 145) based on individual prognosis. Main outcome measures included ABT, postoperative-24 h Scr, age and postoperative-24 h albumin (ALB).

Results

The postoperative-24 h Scr in the death group was significantly higher compared to the survival group (328.71 (153.22)umol/L vs. 214.02 (106.46) umol/L). After adjusting for potential confounders(age, sex, hypertension, chronic renal inefficiency (CRI), renal artery compression, hyperlipidemia, cardiopulmonary bypass (CPB), ALB and intraoperative ventilation time(IVT)), a non-linear relationship was detected between ABT and Scr with an inflection point at 814 ml. Subgroup analysis for patients aged under 47 years and ALB levels above 37.7 g/L revealed a positive correlation between Scr and ABT(β = 0.11, 95%CI (0.03, 0.20), β = 0.14, 95%CI (0.05, 0.23), respectively).

Conclusion

The relationship between ABT and Scr in ATAAD patients exhibits a non-linear pattern with a positive correlation noted when ABT was below 814 ml. This trend was consistent in younger patients and those with higher ALB levels. These findings suggest that the dosage of ABT may impact renal function in ATAAD patients; further research is necessary to clarify the underlying mechanisms.