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Transfusion Service - Transfusion Practices

(P-TS-49) Evaluating the Impact of KabiLyte vs. Normal Saline on Hemolysis During in Vitro Cell Saver Processing

Sunday, October 26, 2025
12:00 PM - 1:00 PM  PT
Background/Case Studies: Intraoperative blood salvage using cell saver devices can be beneficial during surgeries with expected significant blood loss, but there are other important considerations such as increased hemolysis during the wash process. Maintaining red blood cell (RBC) integrity during the wash process is critical, and the composition of the wash solution may influence the overall quality of salvaged RBCs. This in vitro study compared a balanced electrolyte solution (KabiLyte) vs Saline to analyze the difference in red blood cell quality.

Study

Design/Methods: Whole blood collected in CPD anticoagulant was diluted with 0.9% NaCl to achieve a hematocrit of 19.5 – 20.8% (N =6). The diluted blood was then split into two bags, each containing approximately 200 mL, and processed using a cell saver device (CATSmart® Continuous Autotransfusion System) with a low-volume wash protocol—one with Kabilyte and the other with 0.9% NaCl. Samples were collected at 5 timepoints: pre- and post-wash, and at 2, 4, and 24 hours from end of procedure. The parameters evaluated were, %Hemolysis pre/post wash as well as sodium, potassium, total protein, and albumin washouts.

Results/Findings: Comparable %Hemolysis was observed between the two solutions used in the washing process at all timepoints. Significant changes were noted in the post wash electrolyte concentrations consistent with the differences in composition of the two wash solutions. Comparison of post-wash to 24-hour parameters showed sodium levels changed significantly for both saline (p = 0.04) and KabiLyte (p = 0.00). With respect to potassium, when KabiLyte was used, levels remained stable over time (p = 0.71), while a significant change was observed with saline (p = 0.01). Total protein and albumin were also measured, but no significant differences were observed between pre-wash and post-wash timepoints.

Conclusions: When selecting a wash solution for cell saver devices, it is important to consider the potential impact of electrolyte imbalances and hemolysis, as well as their effects on patient outcome.