Castelli Axelle, Libaud Chloé, Decouture Benoît, Bruneau Marine, Depond Mallorie, Forest-Villegas Patricia, Gauthier Olivier, Lafragette Audrey, Touzot-Jourde Gwenola
CRIP, Center for Research and Preclinical Investigation, Oniris Nantes Atlantic College of Veterinary Medicine, Food Science and Engineering, Nantes, France.
i-SEP, Nantes, France.
PLoS One. 2025 May 5;20(5):e0322568. doi: 10.1371/journal.pone.0322568. eCollection 2025.
Autotransfusion is a key strategy in hemorrhagic surgical procedures, reducing risks like disease transmission and immunosuppression due to allogenic transfusion. While conventional devices efficiently process red blood cells by centrifugation, they don't address complications requiring additional platelet transfusions. The innovative same™ device (i-SEP, France), utilizing hollow-fiber filtration, preserves both red blood cells and platelets without damaging cell integrity. This study designed as a prospective randomized controlled trial compared cell concentration and washout performances of two autotransfusion devices, a preclinical version of same™, the conventional centrifugation-based Xtra® (LivaNova, UK); and effects of retransfusion versus no transfusion in 21 Yucatan minipigs submitted to a surgically induced controlled splenic bleeding. Animals were divided into three groups (no-transfusion control group, same group and xtra group) and monitored postoperatively for 72 hours during which serial animal blood samples were collected for hematologic, biochemical and coagulation analyses and tests. Both autotransfusion devices showed high performances in red blood cell yields and concentrations, with a significant superiority of same™ device to preserve platelets. Animals from same and xtra groups retrieved similar rheological profiles and maintained a normal hematocrit compared to no-transfusion control animals. Coagulation profiles stayed within normal range in all groups. No adverse event on animals nor post-mortem sign of thrombosis were identified on autotransfused animals. The same™ device that can therefore be considered as an interesting alternative to conventional centrifugation-based devices. Further experiments are needed to provide evidence of platelets autotransfusion benefits in massive hemorrhagic procedures.
自体输血是出血性外科手术中的一项关键策略，可降低因异体输血导致的疾病传播和免疫抑制等风险。虽然传统设备通过离心能有效地处理红细胞，但它们无法解决需要额外输注血小板的并发症问题。创新的same™设备（法国i-SEP公司）利用中空纤维过滤技术，在不破坏细胞完整性的情况下保存红细胞和血小板。本研究设计为前瞻性随机对照试验，比较了两种自体输血设备的细胞浓缩和冲洗性能，一种是same™的临床前版本，另一种是基于传统离心技术的Xtra®（英国LivaNova公司）；并比较了在21只接受手术诱导的可控脾出血的尤卡坦小型猪中，回输与不回输的效果。动物被分为三组（不回输对照组、same组和xtra组），术后监测72小时，在此期间采集系列动物血样进行血液学、生化和凝血分析及检测。两种自体输血设备在红细胞产量和浓度方面均表现出高性能，same™设备在保存血小板方面具有显著优势。与不回输对照组动物相比，same组和xtra组的动物恢复了相似的流变学特征并维持正常的血细胞比容。所有组的凝血指标均保持在正常范围内。在接受自体输血的动物中未发现对动物的不良事件，也未发现尸检血栓迹象。因此，same™设备可被视为传统离心设备的一个有趣替代方案。需要进一步的实验来提供血小板自体输血在大量出血手术中益处的证据。
