Hemolysis Detected Following the Preparation and Collection of Blood in a Porcine Model Using a Syringe-Based Aspiration Thrombectomy System for Autotransfusion #MMPMID41355530
Dohad S; Hoque MM; Waters JH; Salhanick M
Catheter Cardiovasc Interv 2025[Dec]; ? (?): ? PMID41355530show ga
BACKGROUND: Autologous transfusion of filtered, unwashed blood is a technique to mitigate the effects of blood loss during mechanical thrombectomy, but the degree of hemolysis resulting from this approach and guidance for blood return in this setting is not well understood. AIMS: To assess hemolysis in aspirated and filtered porcine blood using a commercially available syringe-based aspiration thrombectomy blood return device. METHODS: A large-bore, syringe-based aspiration thrombectomy blood return device was tested to assess extent of hemolysis in blood from a porcine model, following the manufacturer's instructions for use (IFU). The aspiration sequence consisted of three stages: blood was aspirated via the inferior vena cava (IVC) from a single animal using a 60-cc syringe through a 24 F catheter (stage 1), filtered through a blood return filter (stage 2), and processed through a transfusion filter (stage 3). Blood was sampled from each stage using a new 3-cc syringe and tested for hemolysis. This was repeated for five separate sequences using the same 60-cc syringe for a total of 15 samples. Plasma free hemoglobin (PFH) was measured as a hemolysis marker. Systemic samples were taken throughout to establish a control PFH value. Samples were compared to control and evaluated against the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Registry threshold of 20 mg/dL PFH for hemolysis. RESULTS: Using the blood return device, PFH levels were elevated relative to control (6.0 +/- 1.8 mg/dL) in all samples, and 33.3% (5/15) of samples exceeded the 20 mg/dL INTERMACS threshold. A significant increase in mean PFH occurred across sequences (p < 0.001), while there was a statistically nonsignificant increase in mean PFH (p = 0.059) across stages. CONCLUSIONS: Porcine blood processed through a syringe-based aspiration thrombectomy blood return device exhibited threshold-exceeding hemolysis, which increased across sequences and remained post-filtration. This study highlights the need to further assess hemolysis when returning aspirated blood to patients during thrombectomy.
Catheter+Cardiovasc+Interv 2025 ; ? (?): ?
