LEUKOCYTE CONTENT IN BLOOD PROCESSED BY AUTOTRANSFUSION DEVICES DURING OPEN-HEART-SURGERY

Autologous red blood cells processed by autotransfusion devices have b ecome increasingly common in major surgery. The finished product, howe ver, often contains varying amounts of leucocytes. We compared leucocy te and their differential counts of blood processed by three autotrans fusion devices (Haemonetics Cell Saver IV Dideco Stat and Dideco Stat- P) during open-heart operations on 25 patients. In addition, a zymosan -induced, luminol-enhanced chemiluminescence method was used to evalua te the activity of neutrophils in prepared autologous blood. High leuc ocyte counts (3.6-10.9x10(9)l(-1)) were found in all saved red blood c ell concentrates. The leucocyte counts of autologous blood produced by the Haemonetics device were lowest (P<0.01) and about one third of th e patients' haematocrit-corrected counts. The proportions of neutrophi ls were higher in salvaged blood than in the blood circulation before anaesthesia or before retransfusion (P<0.01). However, no general acti vation of neutrophils was seen, but the increase in chemiluminescence activity of about 30% that was seen in four patients may suggest an in creased risk of reperfusion injury in such patients after aortic decla mping. In conclusion, all three autotransfusion devices left leucocyte s in the processed red blood cell concentrates, although great differe nces occurred between the devices.