title: [Direct autotransfusion systems deliver blood of inadequate quality].
abstract: OBJECTIVE
  Systems for direct retransfusion of blood salvaged from the surgical field and in drainage systems (direct autotransfusion) have been in use for many years. The quality of the blood obtained with such systems, however, has not been systemically assessed in a comparative manner. The aim of our study was the analysis of the quality of the blood, obtained with three commercially available direct autotransfusion systems (drainage systems with filters).
  
  
  METHODS
  With ethics committee approval and informed consent, 30 patients receiving knee arthroplasty were randomly allocated to three groups. Each group of 10 patients received treatment with one drainage system (Consta Vac, Solcotrans, Haem-o-Trans). In the salvaged blood, we measured cellular elements, variables of coagulation and fibrinolysis, complement activation and cellular elements, both before and after passage of the autotransfusion system.
  
  
  RESULTS
  Analysis revealed a low haematokrit (< 30%) and platelet count (< 80 Gpt/l). The salvaged blood proved uncoagulable and defibrinised with no measurable clotting and fibrinogen; clotting activity, fibrinolysis and complement reaction were grossly induced (TAT, PAP and FDP high, C3 low). The blood was contaminated with cellular debris reflected by concentration of enzymes usually confined to the intracellular space (LDH, elastase, beta-thromboglobulin).
  
  
  CONCLUSIONS
  The systems/filters assessed in this study do not improve quality of blood drained from the surgical field. Retransfusion of such blood can not be recommended.
authors.affiliation: Klinik für Anästhesiologie und Intensivtherapie, Städtisches Krankenhaus, Wismar.
authors.forename: T
authors.initials: T
authors.lastname: Rosolski
authors.forename: K
authors.initials: K
authors.lastname: Mauermann
authors.forename: U
authors.initials: U
authors.lastname: Frick
authors.forename: M
authors.initials: M
authors.lastname: Hergert
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical; D001798:Blood Proteins / Q000032:analysis; D001804:Blood Transfusion, Autologous / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D003165:Complement System Proteins / Q000032:analysis; D005342:Fibrinolysis; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010976:Platelet Count
chemical_list: D001798:Blood Proteins; D006454:Hemoglobins; D003165:Complement System Proteins