Danaparoid(Orgaran)as anticoagulant for autotransfusion with Cell Saver 5 (Haemonetics)

We investigated Danaparoid Sodium (Orgaran) as anticoagulant using three di fferent concentrations (9, 4,5 or 3 U/ml anticoagulant solution) for the us e in the autotransfusion device Cell Saver 5 (Haemonetics). Fresh units of whole blood packs were mixed in the reservoir in a proportion of 5:1 with t he anticoaculant solution. Having started the Cell Saver 5 in the automatic mode,the amount of Danaparoid in the retransfusion blood was determined (c hromogenic Antifactor-Xa test). The lowest concentration of the anticoagula nt was applied in 4 patients with Heparin-Induced Thrombocytopenia Type II undergoing total hip arthroplasty. There was a correlation between the conc entration in the reservoir and in the retransfusion blood. None of the pati ents showed a disturbance of his coagulation system. One of them had slight clotting in the reservoir. We recommend the use of the lower concentration s tested: 4,5 U/ml or,particularly for patients with renal insufficiency or low body weight or expected high retransfusion volumes, 3 U/ml as anticoag ulant concentrations. If the autotransfusion device is used according to th e manufacturerer's instructions there may be virtually no risk of clotting in the Cell Saver or of inhibition of the coagulation system in the patient .