Leucocyte filtration of salvaged blood during cardiac surgery: effect on red blood cell function in concentrated blood compared with diluted blood.
OBJECTIVE
Leucocyte filtration of salvaged blood has been suggested to prevent patients from receiving activated leucocytes during auto-transfusion in cardiac surgery. This study examines whether leucocyte filtration of salvaged blood affects the red blood cell (RBC) function and whether there is a difference between filtration of the concentrated and diluted blood on RBC function.


METHODS
Forty patients undergoing cardiac surgery with cardiopulmonary bypass were randomly divided into a group receiving leucocyte filtration of concentrated blood (High-Hct, n=20) and another group receiving leucocyte filtration of the diluted blood (Low-Hct, n=20). During operation, all the salvaged blood, as well as the residual blood, from the heart-lung machine was filtered. In the High-Hct group, blood was concentrated with a cell saver prior to filtration, whereas in the Low-Hct group, blood was filtered without concentration. RBC function was represented by RBC aggregation and deformability measured by a laser-assisted optical rotational cell analyser and by the RBC 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) contents with conventional biochemical tests.


RESULTS
Leucocyte filtration of diluted blood with a low haematocrit (14+/-4%) did not affect RBC function. However, when the concentrated blood with a high haematocrit (69+/-12%) was filtered, there was a reduction of ATP content in RBCs after passing through the filter (from 1.45+/-0.57 micromol g(-1) Hb to 0.92+/-0.75 micromol g(-1) Hb, p<0.05). For patients who received the concentrated blood, their in vivo RBC function did not differ from those who received diluted blood.


CONCLUSIONS
Leucocyte filtration of the diluted salvaged blood during cardiac surgery does not affect RBC function, but it tends to deplete the ATP content of RBCs as the salvaged blood has been concentrated prior to filtration.
Gu
Y John
YJ
Department of Biomedical Engineering, University Medical Centre Groningen, University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands. y.j.gu@med.umcg.nl
de Vries
Adrianus J
AJ
Hagenaars
J Ans M
JA
van Oeveren
Willem
W
D000368:Aged; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous / Q000379:methods; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D004903:Erythrocyte Aggregation / Q000502:physiology*; D004907:Erythrocyte Deformability / Q000502:physiology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006400:Hematocrit; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies