Amenge James, Scherphof Sabine, Osemwengie Dion, Nierich Arno, Lagerberg Johan W
Department of Obstetrics and Gynaecology, Kenyatta National Hospital, Nairobi, Kenya.
ECCare, Zwolle, the Netherlands.
J Blood Med. 2022 Sep 30;13:549-558. doi: 10.2147/JBM.S367918. eCollection 2022.
Cell salvage is the process by which blood lost in surgery is collected and washed or filtered to produce autologous blood for re-transfusion to the patient. Cell salvage aims to reduce the need for donor blood. Centrifugal cell salvage washing technique is a preferred medical treatment in order to retain lost red blood cells (RBCs) without contaminants. Although this technology very efficiently collects and washes shed blood, it is costly and often impractical or unavailable, especially in middle- or low-income countries. This study assessed two innovative filter devices as an alternative to centrifugal cell salvage technology: a coarse collection filter device (Hemafuse) and a microfiltration device (HemoClear). In contrast to centrifugal technology, both filter devices do not require electricity, nor costly equipment and extensive training. We compared the effectiveness of these filtration technologies to remove plasma constituents and recover and concentrate the cellular components with centrifugal technology (autoLog device).
Whole blood was processed with each technology according to the device manufacturer's instructions. Before and after processing, the blood products were analyzed for supernatant solutes and cellular composition.
The centrifugal technology confirmed its efficacy to remove potentially harmful solutes and capture red blood cells. The microfiltration technology (HemoClear) reached comparable levels of removal of solutes, with a potential advantage over centrifugal technology in the ability to also recover platelets. The coarse filtration technology (Hemafuse) had no washing capacity but, like the microfiltration technology, has the advantage of recovering platelets.
Innovative filtration devices represent an alternative to centrifugal technology in the preparation of autologous blood for reinfusion. The HemoClear technology for the first time enables the recovery of washed platelets and red blood cells. Clinical trials will have to be performed to investigate the clinical value of this new autologous blood product.
细胞回收是指收集手术中流失的血液并进行清洗或过滤，以制备自体血再输回给患者的过程。细胞回收旨在减少对供血的需求。离心式细胞回收清洗技术是一种首选的医疗手段，目的是保留流失的红细胞（RBC）且无污染物。尽管该技术能非常有效地收集和清洗流失的血液，但成本高昂，而且通常不实用或无法实现，尤其是在中低收入国家。本研究评估了两种创新过滤装置作为离心式细胞回收技术的替代方案：一种粗收集过滤装置（Hemafuse）和一种微滤装置（HemoClear）。与离心技术不同，这两种过滤装置都不需要电力，也不需要昂贵的设备和大量培训。我们将这些过滤技术去除血浆成分以及回收和浓缩细胞成分的效果与离心技术（autoLog装置）进行了比较。
按照设备制造商的说明，用每种技术处理全血。处理前后，对血液制品进行上清液溶质和细胞组成分析。
离心技术证实了其去除潜在有害溶质和捕获红细胞的功效。微滤技术（HemoClear）达到了类似的溶质去除水平，在回收血小板的能力方面相对于离心技术具有潜在优势。粗滤技术（Hemafuse）没有清洗能力，但与微滤技术一样，具有回收血小板的优势。
创新过滤装置是制备再输回的自体血时离心技术的一种替代方案。HemoClear技术首次实现了回收清洗后的血小板和红细胞。必须进行临床试验以研究这种新型自体血制品的临床价值。
