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Ann Thorac Surg 1990;49:973-978
© 1990 The Society of Thoracic Surgeons

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Articles

Comparative study of cell saver and ultrafiltration nontransfusion in cardiac surgery

Division of Cardiovascular Surgery and Research Institute of Angiocardiology, Kyushu University Faculty of Medicine, Fukuoka Japan

Accepted for publication January 11, 1990.

^_* Address reprint requests to Dr Nakamura, Department of Cardiovascular Surgery, Medical Center for Sick Children, Fukuoka City. 2-5-1, Tojinmachi, Cyuoku, Fukuoka, Japan.

Hemoconcentration for the establishment of no-donor blood transfusion in open heart surgery was assessed in regard to both the saving of protein and platelets and the exclusion of free hemoglobin. Two different types of hemoconcentrator were compared: the ultrafilter (groun I, 6 patients) and the Cell Saver (group II, 6 patients). The total serum protein level, expressed as the percent recovery of the preoperative value, after hemoconcentration was significantly higher in group I (group I versus group II: total serum protein, 118% versus 87% [p < 0.05]; fibrinogen, 77% versus 50% [p < 0.01]; immunoglobulin, 83% versus 60% [p < 0.011). The platelets also seemed to be welt preserved after hemoconcentration in group I. Although the exclusion of free hemoglobin from plasma was inferior in group I compared with group II, the postoperative plasma free hemoglobin level did not increase in group I. We conclude that use of the Cell Saver in nontransfusion cardiopulmonary bypass might cause a severe depletion of various proteins and thai the ultrafilter is both safer and more useful if employed routinely.

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