Comparison of two different autotransfusion devices: An ex-vivo study.

Abstract

IntroductionDuring surgery, blood is recovered from the surgical field and the autotransfusion device separates and washes the red blood cells (RBC's) after which these can be retransfused to the patient. Autotransfusion devices differ strongly in separation method and washing settings, which may lead to different RBC recovery rates and removal rates of contaminants. The objective of this study was to compare the autoLog IQ^TM (Medtronic) and the Xtra^® (LivaNova) in terms of RBC recovery, quality of the processed blood and processing time.MethodsHuman blood was heparinised and processed with both autotransfusion devices according to their standard protocols. Blood samples were taken from the collection reservoir and from the transfusion bag and analyzed for cell count, heparin removal and cell injury.ResultsThe RBC recovery rates for both devices was 93%. Heparin was almost completely removed in both devices with >99.9%. The autoLog IQ^TM showed significantly better removal of platelets (autoLog IQ vs Xtra; 86.1 ± 2.7 and 78.6 ± 4.4%, p = 0.01) and of leukocytes (autoLog IQ vs Xtra; 39.6 ± 2.7 and 13.4 ± 5.7%, p < 0.001). No other significant differences were observed in removal rates. The volume of RBC concentrated per minute was faster for the Xtra^® (autoLog IQ vs Xtra, 21 ± 3 and 27 ± 2 mL RBC/min, p = 0.007).ConclusionsIn this study both the autoLog IQ^TM and the Xtra^® showed similar RBC recovery rates of 93% and almost all heparin was eliminated. The washing quality of the autoLog IQ^TM device appears to be better, with better removal of platelets and leukocytes. Although both the autoLog IQ^TM and the Xtra^® devices use very different separation techniques and washing protocols, the difference in processing speed and various markers for cell damage in the end product seems trivial.