Autotransfusion - The effects of cell salvage on the filterability of autotransfused red cells

Abstract

30 patients undergoing elective aortic surgery had intraoperative autologous blood transfusion, 15 with the Solcotrans device and 15 with the Haemonetics Cell Saver system Markers of red cell damage and alteration of red cell parameters and biochemistry were studied. Using the St Georges Filtrometer, the filterability of preoperative red cells was compared to that of red cells that had undergone salvage. The indices of filtration measured were the red cell transit time (RCTT) and the number of clogging particles (CP). Various other parameters of red cell damage or known to affect red cell filterability were assessed.

There was no difference between the pre-operative and the salvaged red cell transit times with either autotransfusion device. However, for both devices, there were significantly more clogging particles in the salvaged samples than in the preoperative samples indicating the presence of a subpopulation of rigid cells. This is probably due to an increase in the MVC of damaged cells salvaged with the Solcotrans device, and a relative increase in the MCHC of damaged cells salvaged with the Cell Saver. A comparison of the results obtained for each device, shows that cell washing confers no advantage with respect to the filterability of autotransfused red cells, for differing reasons.