An In Vitro Pilot Study Comparing the Novel HemoClear Gravity-Driven Microfiltration Cell Salvage System with the Conventional Centrifugal XTRA™ Autotransfusion Device.

Autor: Hoetink A; Department of Anesthesiology and Intensive Care, Isala, Zwolle, Netherlands.; Division of Anesthesiology Intensive Care and Emergency Medicine, University Medical Center Utrecht, Utrecht, Netherlands., Scherphof SF; ECCare, Zwolle, Netherlands., Mooi FJ; Department of Anesthesiology and Intensive Care, Isala, Zwolle, Netherlands., Westers P; Department of Epidemiology, UMC Utrecht Julius Center, Utrecht, Netherlands., van Dijk J; Department of Clinical Chemistry, Isala, Zwolle, Netherlands., van de Leur SJ; Department of Clinical Chemistry, Isala, Zwolle, Netherlands., Nierich AP; Department of Anesthesiology and Intensive Care, Isala, Zwolle, Netherlands.
Jazyk: angličtina
Zdroj: Anesthesiology research and practice [Anesthesiol Res Pract] 2020 Sep 08; Vol. 2020, pp. 9584186. Date of Electronic Publication: 2020 Sep 08 (Print Publication: 2020).
DOI: 10.1155/2020/9584186
Abstrakt: Background: In 2013, the World Health Organization reported a shortage of 17 million red blood cell units, a number that remains growing. Acts to relieve this shortage have primarily focused on allogeneic blood collection. Nevertheless, autologous transfusion can partially alleviate the current pressure and dependence on blood banking systems. To achieve this, current gold standard autotransfusion devices should be complemented with widely available, cost-efficient, and time-efficient devices. The novel HemoClear cell salvage device (HemoClear BV, Zwolle, Netherlands), a gravity-driven microfilter, potentially is widely employable. We evaluated its performance in the cardiac postoperative setting compared to the centrifugal XTRA™ autotransfusion device.
Methods: In a split-unit study ( n  = 18), shed blood collected 18 hours after cardiothoracic surgery was divided into two equal volumes. One-half was processed by the XTRA™ device and the other with the HemoClear blood separation system. In this paired set-up, equal washing volumes were used for both methods. Washing effectivity and cellular recovery were determined by measuring of complete blood count, free hemoglobin, complement C3, complement C4, and D-dimer in both concentrate as filtrate. Also, processing times and volumes were evaluated.
Results: The HemoClear and XTRA™ devices showed equal effectiveness in concentrating erythrocytes and leucocytes. Both methods reduced complement C3, complement C4, and D-dimer by ≥90%. The centrifugal device reduced solutes more significantly by up to 99%. Free hemoglobin load was reduced to 12.9% and 15.5% by the XTRA™ and HemoClear, respectively.
Conclusion: The HemoClear device effectively produced washed concentrated red blood cells comparably to the conventional centrifugal XTRA™ autotransfusion device. Although the centrifugal XTRA™ device achieved a significantly higher reduction in contaminants, the HemoClear device achieved acceptable blood quality and seems promising in settings where gold standard cell savers are unaffordable or unpractical.
Competing Interests: Arno P. Nierich is the inventor of the HemoClear filter and holds stock ownership in HemoClear BV, Dr. Stolteweg 70, 8025 AZ Zwolle, Netherlands.
(Copyright © 2020 Anneloes Hoetink et al.)
Databáze: MEDLINE
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