PONE-D-24-33101Comparative evaluation of two autotransfusion devices in a 72h survival swine model of surgically induced controlled visceral blood lossPLOS ONE

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Additional Editor Comments:

Compliment

The paper “Comparative evaluation of two autotransfusion devices in a 72h survival swine model of surgically induced controlled visceral blood loss“ represents an original work in its content. The paper is easy to read, with clearly defined objectives, detailed methodology. The results are clearly presented. I enjoyed reading the paper.

Good luck with the publication

Compliment and Questions

Well written, a model with hypovolemic shock might have shown the benefit of the better platelet recovery.

If the clinical study has already been published (this was mentioned under Discussion, about free Hb concentration), why is the preclinical study findings being published late? Was an updated version of the machine tested in preclinical model?

This study designed as a randomized controlled trial compared cell concentration and washout performances of two autotransfusion devices, a preclinical version of same™, the conventional centrifugation-based Xtra® (LivaNova, UK), with the conclusion that the same™ device showed comparable performances in terms of washout and also better performances regarding cell concentrations (RBC and platelets) without any undesirable effects.

Below are minor comments or questions:

In the abstract you wrote : Yucatan minipigs submitted to a surgically induced controlled splenic bleeding.

In the introduction: in vivo porcine model of surgically-induced abdominal controlled hemorrhage

In the methods: using a previously described animal model of controlled visceral hemorrhage by surgically induced splenic lesions in minipigs [27]. Are the published results in reference 27 the same as in this manuscript?

Did you perform the trials parallel? I ask, because if not, there would have to be a control for every run. Or the experiments are "mixed" in time. I suspect that the latter has happened.

Can you mention the type of the used heparin please?

Issues to do/ to consider

226 for Xtra® device and 3 out of 1O ( please insert zero instead of Capital letter O)

250 same™. Cycle 2 concentrated blood in TB showed an inferior hematocrit and RBC

251 concentration for Xtra® than same™. However, median hematocrits in TB were within

252 the recommended 45 to 65% range [30] for both devices  ( We suggest the use the word “lower” than inferior)

Please replace in the header … visceral blood loss by controlled splenic bleeding

and use in the text always controlled splenic bleeding

Please share AABB guideline referred to in this document on recommended parameters of Auto-transfused blood as pdf as we are not able to download it online due to financial restrictions.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Well written, a model with hypovolemic shock might have shown the benefit of the better platelet recovery.

If the clinical study has already been published (this was mentioned under Discussion, about free Hb concentration), why is the preclinical study findings being published late? Was an updated version of the machine tested in preclinical model?

Reviewer #2: The paper “Comparative evaluation of two autotransfusion devices in a 72h survival swine model of surgically induced controlled visceral blood loss“ represents an original work in its content. The paper is easy to read, with clearly defined objectives, detailed methodology. The results are clearly presented. I enjoyed reading the paper.

Good luck with the publication!

Reviewer #3: This study designed as a randomized controlled trial compared cell concentration and washout performances of two autotransfusion devices, a preclinical version of same™, the conventional centrifugation-based Xtra® (LivaNova, UK), with the conclusion that the same™ device showed comparable performances in terms of washout and also better performances regarding cell concentrations (RBC and platelets) without any undesirable effects.

I have only minor comments or questions:

In the abstract you wrote : Yucatan minipigs submitted to a surgically induced controlled splenic bleeding.

In the introduction: in vivo porcine model of surgically-induced abdominal controlled hemorrhage

In the methods: using a previously described animal model of controlled visceral hemorrhage by surgically induced splenic lesions in minipigs [27]. Are the published results in reference 27 the same as in this manuscript?

Please replace in the header … visceral blood loss by controlled splenic bleeding

and use in the text always controlled splenic bleeding

Did you perform the trials parallel? I ask, because if not, there would have to be a control for every run. Or the experiments are "mixed" in time. I suspect that the latter has happened.

Can you mention the type of the used heparin please?

By the way, good work :)

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Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Comparative evaluation of two autotransfusion devices in a 72h survival swine model of surgically induced controlled splenic bleeding

PONE-D-24-33101R1

Dear Dr. Touzot-Jourde,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Stephen Emilio Njolomole, MB,BS, MPH

Guest Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: (No Response)

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: N/A

Reviewer #3: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: All comments have been addressed satisfactorily. This is a well written manuscript. Wish you Good luck!

Reviewer #2: The author answered the reviewers questions and corrected the manuscript in accordance with their suggestions.

I recommend the publication of this manuscript.

Reviewer #3: Thank you for answering my questions and considering my comments. The manuscript is well prepared and easy to read.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: Yes:  Aby Abraham

Reviewer #2: No

Reviewer #3: No

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