Quality control and maintenance of intraoperative cell salvage instruments.

Objectives: Intraoperative cell salvage (ICS) is broadly used in high-risk surgical procedures to facilitate rapid autologous red blood cell transfusion, minimizing the need for allogeneic blood and its associated risks. However, standardized guidelines are lacking for the quality control of ICS devices.

Methods: We retrospectively assessed biannual quality control tests performed on 8 ICS devices at our institution between 2017 and 2023. The quality control assessments included visual inspection for hemolysis, albumin levels, potassium (K+) levels, and free hemoglobin levels, as well as microbial cultures.

Results: Among 90 quality control tests, albumin and K+ levels were consistently within acceptable ranges. However, visual inspections revealed 14 and 20 instances of unacceptable hemolysis and free hemoglobin levels, respectively. Two devices exhibited higher frequencies of these unacceptable outcomes. Most microbial cultures identified contaminants, with Klebsiella pneumoniae being the only notable pathogen. Follow-up simulations demonstrated acceptable performance, indicating equipment reliability.

Conclusions: Our findings highlight the need for standardized quality control protocols for ICS devices. Although current guidelines are limited, our biannual quality control standard is both practical and effective. We hope our findings provide a framework for other institutions aiming to optimize ICS device performance.