Quality of Red Blood Cells Using Autotransfusion Devices: A Comparative Analysis

Trillium Health Centre, Mississauga, Ontario, Canada

^* Address correspondence to: Cyril J. Serrick, MSc, CPC, CCP, Trillium Health Centre, Mississauga Site, 100 Queensway Wess, Mississauga. ON L5B 1B8. E-mail: cserrick@thc.on.ca

Received: 22 March 2002
Accepted: 21 January 2003

Abstract

Cell salvage devices are routinely used to process and wash red blood cells (RBCs) shed during surgical interventions. Although the principle theory of cell saving is the same, the actual process to achieve this is very different from one device to another. The purpose of this study was to compare the quality of washed, concentrated RBC produced by five very different cell-saving devices, specifically the Cobe BRAT 2, Medtronic Sequestra 1000, Haemonetics Cell Saver 5, Medtronic Autolog, and the Fresenius CATS. Reservoir and washed red blood cells were analyzed for hematocrit (Hct), platelets (PLT), leukocytes (WBC), potassium (K+), heparin, plasma-free hemoglobin (PFH), RBC mass recovery and recovery rate. The Haemonetics and BRAT 2 had the highest RBC recovery. All devices adequately removed heparin and potassium. The Medtronic Autolog had the highest removal of platelets and PFH; whereas, the BRAT had the lowest. Although the Autolog had the highest leukocyte removal, leukocytes were not adequately washed out by any of the autotransfusion devices. In conclusion, although all cell- saving devices use the same theory of centrifugation, the actual quality of the washed RBC product differs widely from one device to another.