Discusssion

Autologous blood processing systems, or cell savers have become common place during a large number of cardiac surgery procedures. The theory of collecting shed blood, washing the cells and returning them to the patient is thought to reduce homologous transfusions and the degree of anaemia commonly experienced in cases involving cardiopulmonary bypass. Most practitioners would agree that ‘receiving your own blood back during a procedure is preferable to receiving donor blood’. Homologous transfusions are known to incur a number of risks to patients, some potentially serious and this resource is costly and finite. Autotransfusion techniques alleviate some of these risks and many studies demonstrate patients have higher haemoglobin concentrations during and immediately post-surgery when these systems are utilised. However, little is known about the influence of cell salvage on red cell structure, function and longevity. Do processed red blood cells function satisfactorily in the days following their re-infusion? Or are cell savers simply delaying an inevitable transfusion due to early destruction of processed cells?