title: Transfusion of platelet concentrates from pooled buffy-coats: comparison of bedside vs. prestorage leukofiltration.
abstract: Prestorage leucocyte filtration of platelet concentrates (PC) has been considered to be superior to bedside filtration with regard to the incidence of nonhaemolytic transfusion reactions (NHTR) or HLA-alloimmunization. It is currently a matter of debate whether prestorage leucocyte filtration has an impact on the storability of platelets and on the transfusion results of PC. In a clinical retrospective study we investigated the transfusion results of PC from pooled buffy-coats (PC-BC) in haematological patients without known refractoriness to platelets, and compared bedside filtration (n = 228/36 patients) vs. prestorage filtration (n = 271/25 patients). Leukocyte and platelet content of the PC, duration of storage, platelet count of the patient before transfusion and 20 h after transfusion were determined and platelet increment and corrected count increment (CCI) 20 h after transfusion were calculated. The mean leucocyte content of the bedside filtered PC was 66 +/- 50 x 106 and < 0.1 x 106 for the prestorage filtered PC (P < 0.001). Mean platelet content of the PC (2.6 x 1011 vs. 2.7 x 1011) and the duration of PC storage (2.7 vs. 2.6 days) were almost identical in both groups. The platelet increment after 20 h (14.6 x 109 L-1 vs. 14.9 x 109 L-1) was equal for both groups, but CCI values were significantly higher for the bedside filtered PC (14.1 +/- 9.5 vs. 11.4 +/- 6.8) (P = 0.008). Correlation with the storage time revealed that CCI levels were higher for bedside filtered PC after short-term storage (< 36 h) (P = 0.014), but declined more rapidly compared with prestorage filtered PC. A patient-based analysis including fewer cases revealed superior but nonsignificant results for bedside filtration. In conclusion, bedside filtered PC-BC resulted in better CCI results after short-term storage, but values equalized with prestorage filtered PC-BC after longer storage intervals. Prestorage-leucocyte filtration did not improve platelet recovery in vivo, but CCI values decreased only moderately throughout storage. Both preparations showed excellent transfusion results even after a 5-day storage interval.
authors.affiliation: Institute of Immunology and Transfusion Medicine; Department of Hematology, University of Lübeck School of Medicine, Germany. muellerst@immu.mu-luebeck.de
authors.forename: M
authors.initials: M
authors.lastname: Müller-Steinhardt
authors.forename: P
authors.initials: P
authors.lastname: Schlenke
authors.forename: T
authors.initials: T
authors.lastname: Wagner
authors.forename: H
authors.initials: H
authors.lastname: Klüter
mesh_terms: D001793:Blood Preservation / Q000379:methods; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D010976:Platelet Count; D017713:Platelet Transfusion