Related Experiment Video
Updated: Mar 15, 2026
Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
Published on: March 14, 2017
Reinfusate Heparin Concentrations Produced by Two Autotransfusion Systems
Willem Frederik Buys1, Mathilde Buys1, Andrew Ian Levin1
1Department of Anesthesiology and Critical Care, Faculty of Health Sciences, University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa.
Objectives:
Cell saver reinfusate ideally should contain low, clinically insignificant heparin concentrations. The American Association of Blood Banks has defined the clinically insignificant threshold as 0.5 IU/mL. Furthermore, there is uncertainty about the meaning of cell saver "heparin elimination rates." These concerns prompted the authors' independent investigation of reinfusate heparin concentrations of devices used in their institution. It was hypothesized that cell saver reinfusates contain clinically insignificant heparin concentrations.
Design:
Two prospective, pragmatic, sequential, observational, single-center studies.
Setting:
University teaching hospital.
Participants:
A total of 32 and 31 patients for on-pump cardiac surgery were enrolled in the Sorin (Dideco) Electa and Sorin Xtra studies, respectively.
Interventions:
None.
Measurements And Main Results:
Postcardiac surgery reinfusate heparin concentrations were measured using a modified anti-Xa chromogenic assay. Heparin concentrations above 0.5 IU/mL were present in 56% (95% confidence interval, 35% to 68%) of Sorin Xtra reinfusates. Heparin concentrations in the Sorin (Dideco) Electa reinfusates were lower than recommended in 29 of 32 reinfusates. Only 3 of 32 Sorin (Dideco) Electa reinfusates (9.4%; 95% confidence interval 3.2% to 24%) exhibited heparin concentrations exceeding 0.5 IU/mL.
Conclusions:
Sorin (Dideco) Electa reinfusates contained heparin concentrations below the American Association of Blood Banks recommended threshold in 90.6% of cases, while Sorin Xtra reinfusate heparin concentrations exceeded this recommendation in 56% of cases. Measurement of cell saver reinfusate heparin concentrations necessitates the use of a modified chromogenic assay. Studies explicitly should confirm that such a modification was indeed used. Periodic quality control of reinfusate composition is recommended.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:09One-Compartment Model: IV Infusion
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
01:25Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration