What is the cell saver?

Bloodless medical procedures depend upon the skill of highly trained surgeons, nurses, perfusionists and other supportive personnel. Included in the care of patients undergoing such procedures are machines and  equipment whose use requires highly technical skill  to assure positive patient outcomes after surgery.  One such tool is the cell saver. What is the function of this machine during a bloodlesss procedure?

What is the cell saver?

The cell saver is a machine that collects blood lost through surgery.   There are two types of machines that are used to perform this procedure:

1.RBC (red blood cell) washing type.  This type of machine collects, washes and removes the red blood cells by centrifuge.  It then reinfuses them. 

These RBC wahing devices can also cleanse toxins from the blood.  They also remove platelets and clotting factors (both are important in blood clotting)  These machines are also of variable design and capacity.  They are also more costly but have more positive patient outcomes.

2. Hemofiltration type.  The hemofiltration type just collects blood, filters  and reinfuses it. These machines can return all of the blood elements including the platelets and clotting factors.  The contaminants are also present.

What are indications and contraindications for Cell Saver?
Generally, cell saver use is likely if the blood loss is 1000ml (one liter) or, in the past, 20% of the patient's estimated volume.  Also, if a procedure has  usually required a blood transfusion. A list of some common surgeries where it is used are as follows:

Cardiac - valve replacement.

Orthopedic - major spine surgery.
                     bilateral knee replacement.

Urology - radical retropubic prostatetomy.
                Cystectomy

Vascular - thoraco abdominal-aortic aneurysm repair.

Contraindications

Blood that has been contaminated with urine, feces, bone fragments or amniotic fluid.

Malignancy

Hematologic disease - sickle cell or thallessemia.

If you are contemplating surgery, talk with your physician or surgeon regarding the possibility of cell saver during the procedure. As individual factors must be taken into consideration.

Sources:

Freischlag, Julie, "Intraoperative blood salvage in vascular surgery - worth the effort? http://www.ccforum.com/
Waters, Jonathan H., "Indications and contraindications of cell salvage" http://www.bplmedical.com/