A cell saver is a medical device used during surgical procedures to collect, process, and reinfuse a patient’s own blood. This technology, also known as autotransfusion or cell salvage, helps reduce the need for donor blood transfusions. Recycling the patient’s own blood minimizes blood loss and complications.
How Cell Savers Operate
Cell savers operate in several steps, beginning with blood collection from the surgical site. As blood is lost during surgery, a suction system draws it into a sterile reservoir. An anticoagulant solution is mixed with the collected blood to prevent clotting.
After collection, the blood is filtered to remove debris and unwanted materials, such as fat. The filtered blood then moves into a centrifuge bowl, spun at high speeds (e.g., 5600 rpm). This centrifugation separates denser red blood cells from other components like plasma, platelets, white blood cells, and the anticoagulant.
Once separated, the red blood cells are washed with a sterile saline solution. This washing step removes impurities, remaining anticoagulant, free hemoglobin, and other waste products. Finally, clean red blood cells, suspended in saline, are collected into a transfusion bag for reinfusion.
When Cell Savers Are Used
Cell savers are used in surgical procedures where significant blood loss is anticipated. This includes major orthopedic surgeries such as spinal fusions, hip, or knee replacements. Cardiac surgeries, including coronary artery bypass grafting (CABG) and valve replacements, also frequently use cell savers.
The device is also used in vascular surgery (e.g., aortic aneurysm repair) and trauma cases requiring immediate blood replacement. Liver transplantations and obstetric procedures with a high bleeding risk, such as cesarean sections for placenta previa, are other indications. Its use helps manage blood loss efficiently across a range of medical specialties.
Advantages of Autotransfusion
Autotransfusion, using a patient’s own blood, offers several advantages. A primary benefit is the reduced risk of transfusion reactions, such as allergic responses or fever, common with donor blood. Since the blood originates from the patient, their body readily accepts it, minimizing immunological complications.
Autotransfusion also eliminates the risk of transmitting blood-borne diseases like HIV or hepatitis. This provides enhanced safety for the patient. Cell savers conserve donor blood supplies, helping manage blood bank resources. Patients often experience psychological comfort knowing they are receiving their own blood, especially for those with religious or personal objections to donor transfusions.
Situations Where Cell Savers Are Not Suitable
Despite their benefits, cell savers are not appropriate for all surgical situations. If the surgical site is infected, reinfusing blood collected from that area could spread the infection throughout the patient’s body. Similarly, in cases of malignancy, there is a theoretical risk that reinfusing blood containing cancer cells could potentially spread the disease.
Contamination of the surgical field with substances like bowel contents, urine, or other non-sterile materials also typically contraindicates the use of a cell saver, as these contaminants cannot be entirely removed. Certain medications, such as topical hemostatic agents, can interfere with the blood processing or harm the patient if reinfused. Conditions involving fragile red blood cells, such as homozygous sickle cell disease, are also generally considered contraindications due to the risk of red cell lysis during processing.