Comparison of Washing Efficiency and Recovery of Blood Cells Between Centrifugation, Coarse Filtration and Microfiltration Techniques to Prepare Autologous Blood for Transfusion

Abstract

Purpose

Cell salvage is the process by which blood lost in surgery is collected and washed or filtered to produce autologous blood for re-transfusion to the patient. Cell salvage aims to reduce the need for donor blood. Centrifugal cell salvage washing technique is a preferred medical treatment in order to retain lost red blood cells (RBCs) without contaminants. Although this technology very efficiently collects and washes shed blood, it is costly and often impractical or unavailable, especially in middle- or low-income countries. This study assessed two innovative filter devices as an alternative to centrifugal cell salvage technology: a coarse collection filter device (Hemafuse) and a microfiltration device (HemoClear). In contrast to centrifugal technology, both filter devices do not require electricity, nor costly equipment and extensive training. We compared the effectiveness of these filtration technologies to remove plasma constituents and recover and concentrate the cellular components with centrifugal technology (autoLog^® device).

Methods

Whole blood was processed with each technology according to the device manufacturer’s instructions. Before and after processing, the blood products were analyzed for supernatant solutes and cellular composition.

Results

The centrifugal technology confirmed its efficacy to remove potentially harmful solutes and capture red blood cells. The microfiltration technology (HemoClear) reached comparable levels of removal of solutes, with a potential advantage over centrifugal technology in the ability to also recover platelets. The coarse filtration technology (Hemafuse) had no washing capacity but, like the microfiltration technology, has the advantage of recovering platelets.

Conclusion

Innovative filtration devices represent an alternative to centrifugal technology in the preparation of autologous blood for reinfusion. The HemoClear technology for the first time enables the recovery of washed platelets and red blood cells. Clinical trials will have to be performed to investigate the clinical value of this new autologous blood product.

Keywords:

• cell salvage
• blood salvage
• cell salvage technology
• cell saver
• blood filter

Abbreviations

CPD, citrate-phosphate-dextrose; Hb, hemoglobin; Ht, hematocrit; K+, potassium; KEMSA, Kenya Medical Supplies Authority; MA, maximum amplitude; MCV, mean corpuscular volumes; Plt, platelet; RBC, red blood cell; TEG, thromboelastography; WBC, white blood cell.

Data Sharing Statement

Raw data files are available upon request from the corresponding author.

Ethical Approval

This study was approved by Sanquin’s Research Medical Ethical committee, in accordance with the standards laid down in the 1964 Declaration of Helsinki.

Consent for Publication

HemoClear BV consents to the publication of these data.

Acknowledgments

We thank Richard Vlaar, Mya Go and Eric Gouwerok for their assistance in performing the laboratory analyses.

Disclosure

James Amenge purchased hemafuse devises and for presenting the study result in a virtual internal conference on bloodless surgery. He received manufacturer’s training on hemafuse devices and used the hemafuse device in a patient. Dion Osemwengie is an employee of HemoClear BV. Arno Nierich holds stock in HemoClear BV. The other authors report no conflicts of interest in this work.

Additional information

Funding

This study was funded by HemoClear BV.