A Novel Centrifugation Method Using a Cell Salvage Device Offers an Alternative to the Use of Leukocyte-Depleting Filters for Autologous Blood Transfusions

J Extra Corpor Technol. 2016 Dec;48(4):168-172.

Abstract

Autotransfusion protocols often use the use of costly filters, such as leukocyte-depleting filters (LDFs), to minimize reinfusion of activated leukocytes and inflammatory mediators associated with reperfusion injury (RI). LDFs are used extensively in hospital settings; however, they represent an additional capital expenditure for hospitals, as well as a constraint on the reinfusion rate of blood products for health-care providers. We compared a commonly used LDF to a novel centrifugation method employing a widely used cell salvage device. Complete blood counts and enzyme-linked immunosorbent assays (ELISAs) measuring tumor necrosis factor-α (TNF-α) and interleukin-2 (IL-2) were performed to compare the efficacy of these methodologies. The LDF removed, on average, 94% of all leukocytes, including 96% of neutrophils. The centrifugation method removed, on average, 89% of all leukocytes, including 91% of neutrophils and resulted in a highly concentrated red blood cell product. Our results suggest both methods offer equivalent leukocyte reduction. TNF-α was also comparably reduced following our novel centrifugation method and the LDF method and IL-2 levels were undetectable in all samples. These results indicate our novel centrifugation method may preclude the need for a LDF during select autotransfusion applications.

Keywords: blood transfusion; cardiopulmonary bypass; inflammatory mediators (e.g, cytokines); leukocyte-depleting filter; leukocytes.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Transfusion, Autologous / instrumentation*
  • Blood Transfusion, Autologous / methods
  • Cattle
  • Cells, Cultured
  • Centrifugation / instrumentation*
  • Equipment Design
  • Equipment Failure Analysis
  • Leukocyte Count
  • Leukocyte Reduction Procedures / instrumentation*
  • Leukocytes / cytology*
  • Operative Blood Salvage / instrumentation*
  • Ultrafiltration / instrumentation*