Reinfusate Heparin Concentrations Produced by Two Autotransfusion Systems.

Area of Science:

• Cardiovascular Surgery
• Transfusion Medicine
• Biomedical Engineering

Background:

• Cell saver reinfusate ideally has low heparin concentrations, below the American Association of Blood Banks' (AABB) 0.5 IU/mL threshold.
• Uncertainty exists regarding cell saver heparin elimination rates and reinfusate heparin concentrations.

Purpose of the Study:

• To investigate reinfusate heparin concentrations from cell saver devices used in a university teaching hospital.
• To determine if cell saver reinfusates meet clinically insignificant heparin concentration thresholds.

Main Methods:

• Two prospective, observational studies were conducted at a university teaching hospital.
• Heparin concentrations in reinfusates from Sorin (Dideco) Electa and Sorin Xtra cell savers were measured using a modified anti-Xa chromogenic assay in patients undergoing on-pump cardiac surgery.
• 32 patients were enrolled for the Electa study and 31 for the Xtra study.

Main Results:

• The Sorin Xtra device had reinfusate heparin concentrations exceeding 0.5 IU/mL in 56% of cases.
• The Sorin (Dideco) Electa device showed heparin concentrations above 0.5 IU/mL in only 9.4% of cases (3 out of 32).
• 90.6% of Sorin (Dideco) Electa reinfusates met the AABB heparin threshold.

Conclusions:

• The Sorin (Dideco) Electa device demonstrated significantly lower reinfusate heparin concentrations compared to the Sorin Xtra device.
• Accurate measurement of cell saver reinfusate heparin requires a modified chromogenic assay.
• Periodic quality control of cell saver reinfusate composition is recommended to ensure patient safety.