Background: Erythrocyte salvage, the collection
of a patient’s blood shed from the surgical wound, is one
aspect of blood management. Previous investigators have examined
salvaged blood for content; however, to our knowledge, none have
examined the viability of erythrocytes after exposure to the chemical
and thermal reactions produced by motorized instruments and polymethylmethacrylate
during surgery. The purpose of this study was to determine the viability
of salvaged erythrocytes from patients undergoing primary total
joint arthroplasty with cement.
Methods: Erythrocyte viability studies were performed
on specimens from three subjects with use of a double isotope-labeling
technique employing chromium-51 and technetium-99m. With use of
a fresh blood specimen obtained prior to surgery and a specimen
of salvaged blood that had been recycled, washed, and filtered with
use of the Cell Saver, the viability of the Cell-Saver-processed
erythrocytes, labeled with chromium-51, was calculated on the basis
of the technetium-99m-labeled red blood-cell mass.
Results: The mean erythrocyte viability (and standard
deviation) in blood salvaged with use of the Cell Saver was 88.0% ±
3.8%. The standard of the American Association of Blood
Banks for minimum erythrocyte viability in adequately cross-matched
allogeneic blood or predeposited autologous blood is 70%.
Conclusions: The high rate of viability of the erythrocytes
in this study shows that the Cell Saver is a valuable adjunct to
other blood management techniques for patients having total joint
arthroplasty. We believe that the very high mean rate of erythrocyte viability
and the extremely small standard deviation in our three subjects,
as compared with the standards of the American Association of Blood
Banks, made additional study subjects unnecessary.