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Although current autotransfusion devices have platelet sequestration capabilities, each has a unique technology to achieve the final platelet product. The purpose of this study was to assess the quality and quantity of platelets sequestered by three different autotransfusion devices. The three commercially available autotransfusion devices evaluated were Fresenius C.A.T.S (closed spiral chamber), Cobe BRAT 2 (Baylor bowl), and Haemonetic Cell Saver 5 (Latham bowl). Platelet sequestration was preformed in the automatic mode following the manufacturer's recommended sequestration protocols. The total number of platelets sequestered, percent recovery, and percent platelet function were assessed. Each device behaved similarly. There was a 2- to 3-fold increase in platelet count compared with baseline with only approximately 50-60% recovery, whereas there was approximately a 10% decrease in platelet function after processing compared with baseline. No statistical difference was noted in platelet function between the respective machines. However, there was a significant loss of platelet function observed with the actual process regardless of autotransfusion device used.

Controversy still exists on the validity of processing a partial bowl during the collection of shed blood lost through surgery during cell salvaging. The purpose of this study was to assess the quality of red blood cells produced from a partial bowl of autologous suctioned blood using the Haemonetics Cell Saver 5. Suctioned blood was collected from 17 patients undergoing cardiac surgery. A partially filled cell saver bowl was washed with 1500 mL of NaCl. Reservoir and processed blood samples were examined for potassium, leukocytes, hematocrit, platelets, and plasma-free hemoglobin and then compared with 22 previously studied full bowls. Results are summarized in the table below: In conclusion, the Haemonetics Cell Saver 5 can produce a quality product from washing a partial bowl with a better washout of white blood cells compared with a full bowl. However, there is a reduction in red blood cell recovery.

The purpose of this study was to evaluate the quality of washed, concentrated red blood cells (RBCs) produced by the new Electa autotransfusion device from Cobe Cardiovascular (Dideco). Blood was collected intraoperatively in 16 patients undergoing cardiac surgery for whom routine cell savage was being used and then washed using the Electa. According to the manufacture's protocol. 125-mL bowls were used in the standard wash program. Reservoir and washed RBCs were analyzed for platelets (PLTs), leukocytes (WBCs), potassium (K+), and plasma-free hemoglobin (PFH) removal, as well as, hematocrit (Hct) and RBC recovery. The Electa cell saver produced a product with an average Hct of 58+/-5% and a RBC recovery rate of 87+/-10%. Its removal of waste products resulted in the washout of 54+/-18% WBCs, 87+/-6% PLTs, 91+/-4% K+, and 77+/-17% PFH. The Electa produces a good-quality washed RBC product that is comparable with other autotransfusion devices on the market.

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.