The role of filtration in the provision of leukocyte poor red cells to multitransfused patients.
Five techniques for the preparation of leukocyte poor red cells were investigated to compare their efficiency in preventing febrile transfusion reactions with their cost of production, in order to establish a cost-effective transfusion programme for chronically anemic patients. Leukocyte depletion and preparation costs per unit for the products were:--microaggregate filtered red cells (MF): 25% leucocyte removal at a cost of $A2; buffy coat poor red cells (BCP): 70% at $A2; washed buffy coat poor red cells (WBCP): 88% at $A28; cotton wool filtered red cells (CWF): 93% at $A23; reconstituted frozen red cells (FC): 97% at $A80. The 5 products were transfused into 103 thalassemia patients with a documented history of febrile transfusion reactions. Reaction rates, expressed as a percentage of units transfused over a 12 mth period (MF 7%, BCP 0.3%, WBCP 0.1%, CWF 0.1%, FC 0.2%) correlated well with the degree of leukocyte depletion. The cost of CWF was reduced by a further 10% using the filter in line during the transfusion. Serum from these patients was screened for leukocyte and platelet antibodies using microlymphocytotoxic, granulocyte immunofluorescence and platelet immunofluorescence assays. There was no correlation between the antibodies present and the type of leukocyte poor product required by a patient to prevent a febrile reaction. A progressive regimen of transfusion (BCP to CWF to FC as the patient reacts) has now been adopted, with considerable cost saving.
D001792:Blood Platelets / Q000276:immunology; D001793:Blood Preservation; D001803:Blood Transfusion / Q000379:methods*; D002469:Cell Separation / Q000379:methods; D017707:Erythrocyte Transfusion; D005374:Filtration; D006098:Granulocytes / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000032:analysis; D007958:Leukocyte Count; D007962:Leukocytes / Q000276:immunology; D013789:Thalassemia / Q000628:therapy; D065227:Transfusion Reaction
D006680:HLA Antigens; D007518:Isoantibodies