 Different sorts of direct autotransfusion systems in wide use today
Added: 10/17/2005 |
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Recent researches demonstrated that direct autotransfusion systems can provide blood of inadequate quality. That can be potentially dangerous, if such blood is used for further retransfusion. And it is vital to study all the parameters and conditions that can affect blood quality during the purifying process in direct autotransfusion systems of any sort.
Autotransfusion is a technique that has been in place for a very long time now. In fact, that was the first method of retransfusion because at those times there were no blood banks and people didn't even know about blood groups. So, the only way of retransfusion was to take blood from a patient to give it back to him later. This method was in wide use for surgical operation and in many other cases.
Later blood groups were discovered which allowed building blood banks for retransfusion. All that made retransfusion much easier and faster. But that also caused new problems, such as transmission of virus infections (HIV infection, Hepatitis B virus and hepatitis C virus infections, Cytomegalovirus and a great number of other viruses), bacterial infection of blood components and different sorts of hemolytic reactions. So, autotransfusion is still used in many cases for preoperative donation (in that case, erythropoietin is usually used) and that allows to provide a patient with blood which is necessary during the surgery and to avoid different problems that retransfusion might cause.
Preoperative autotransfusion guarantees that blood has no infection and there won't be any hemolytic reaction. It is also possible to collect blood during the surgical operation and purify it later using direct retransfusion systems for further use of it or only its components. Autotransfusion systems are also widely used to purify drained blood (similar systems are also employed for direct retransfusion to purify blood obtained from the surgical field). But as it was shown by the latest study, direct autotransfusion systems do not provide the necessary quality of a product and blood of inadequate quality can result from purifying.
In direct autotransfusion systems purifying usually consists of two different stages. At the initial stage, separation is performed when the blood which is going to be processed is placed into bowl. The second stage consists in washing. The results of different studies offered several options that allow improving elimination of solutes. This means that there are parameters, like lowering hematocrit before the actual blood processing, increasing it after the process and increasing the washing volume, which can significantly affect the quality of the processed blood.
Such tests have proved that the efficiency of the washing stage performed by direct autotransfusion systems is very low. And this means that quality of the product obtained with these systems can be improved by complete excluding of the washing stage from the overall procedure. The systems that are now in use in most of the cases produce blood of inadequate quality that is not recommended for the use in autotransfusion and, of course, they must not be used for retransfusion. A complete revision of the direct autotransfusion systems' design is necessary to achieve the appropriate quality of blood obtained in the process. And it is not recommended for usage in its present condition.
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