Impact of Reservoir Hematocrit and Processing Parameters on the Quality of Processed Blood Product

Introduction

The red blood cell recovery rate and washing efficiency of centrifugal devices used for intraoperative autologous transfusion (IAT) impact safety, purity and potency of the processed product. Standard programs of most IAT devices have shown satisfactory performance during vascular surgery [1], cardiothoracic surgery [2] and major orthopedic surgery [3] [4] [5] [6] [7]. However, accurate data on processing at high speeds are limited. The operating principles of centrifugal equipment are based either on discontinuous (DF) or continuous flow (CF). DF devices employ conical or cylindrical bowl geometries, which may affect results of the washing procedures. Manufacturers provide defined pre-programmed washing procedures with various washing speeds. In addition, operator-defined options are available, allowing for alteration of processing parameters of centrifuge speed and flow rates. Although changes that may affect the characteristics of the blood product are indicated, no exact data are provided.

The goal of this study is to perform a well-defined laboratory comparison of the processing speed and quality of the washed red cell product of three autotransfusion devices, each with operating principles based on different technology. Three speeds were studied in standard, medium and high flow programs using non-distributable donor red cells reconstituted with compatible plasma and at three dilutions with saline, simulating conditions in the operating room.

References

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1 Coulter, Miami, Florida

2 Dade-Behring, Deerfiled, Illinois

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