Quality of Processed Blood for Autotransfusion

Abstract

Centrifugal red blood cell washers for intraoperative autotransfusion process shed blood during surgery. In this study, the quality of processed fresh, human bank blood was assessed in a standardized laboratory setting during standard, medium, and high flow processing. Red cell recovery rates and plasma washout efficiencies were compared using three different devices. The accurate parameters measuring effectiveness and product quality were red cell mass (RCM) flow rate and the plasma washout efficiency. Cobe BRAT 2, a system with discontinuous flow (DF) and a cylindrical centrifuge bowl, permitted processing in standard and medium flow of 26 and 35 mL RCM/min, respectively, with washout of residual plasma albumin of 93.2 and 91.2%. The Medtronic Sequestra 1000, a DF system with a conical centrifuge bowl processed blood at 15 and 23 mL RCM/min and eliminated plasma albumin with 98.4 and 96.8% washout during standard and medium flow, respectively, with significant red cell loss occurring during medium flow. The respective speeds of high-flow programs with BRAT 2 and Sequestra 1000 were 15 and 22 mL RCM/min, related to a hematocrit in the holding bag, less than that of the incoming blood from the reservoir. Washout was 58.2 and 58.3%, respectively. Fresenius CATS, a continuous flow (CF) device, produced flow rates of 19, 24, and 43 mL RCM/min and plasma albumin elimination of 97.8, 94.4, and 93.3% in standard, medium, and high-flow, respectively. Holding bag hematocrits with CF exceeded that of DF. Standard, medium, and high-flow programs of CATS may be used without restriction.