Universal leukodepletion of blood components results in a significant reduction of febrile non-hemolytic but not allergic transfusion reactions.
BACKGROUND
Universal leukodepletion of blood components to prevent acute non-hemolytic transfusion reactions (NHTRs) is still a subject of debate.


METHODS
Transfusion-associated NHTRs observed at our hospital in the last 6 years were retrospectively analyzed. Buffy-coat depleted red blood cells (bc-RBCs), and if indicated, leucodepleted post-storage (ld-RBCs) were initially used. In April 1997, universal leukodepletion was implemented at our hospital, and thereafter only prestorage ld-RBCs were used. All platelet concentrates transfused during this time were prestorage filtered single-donor apheresis platelets (SDAPs).


RESULTS
A total of 163,090 blood products were transfused from April 1995 to April 2001 (bc-RBC: n=34,040 units; ld-RBC: n=66,967; SDAP: n=14,516; FFP: n=47,567). The number of post-transfusion febrile NHTRs occurring with each blood product was 65 (0.19%) for bc-RBCs, 8 (0.16%) for post-storage ld-RBCs, 16 (0.03%) for prestorage ld-RBCs, 16 (0.11%) for SDAPs, and 10 (0.02%) for FFP. Allergic reactions (n=116) were most frequently observed after SDAP transfusion (0.32%) and occurred at a similarly low rate after transfusion of all other blood components (0.03-0.08%).


CONCLUSIONS
In conclusion, acute NHTRs rarely occur after the use of leukodepleted blood components. Prestorage appears to be more effective than post-storage leukodepletion in preventing febrile reactions following a blood transfusion.
Pruss
Axel
A
Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany. axel.pruss@charite.de
Kalus
Ulrich
U
Radtke
Hartmut
H
Koscielny
Jürgen
J
Baumann-Baretti
Bärbel
B
Balzer
Dominik
D
Dörner
Thomas
T
Salama
Abdulgabar
A
Kiesewetter
Holger
H
D001781:Blood Component Removal / Q000009:adverse effects* / Q000379:methods*; D016913:Blood Component Transfusion / Q000379:methods*; D001793:Blood Preservation; D005334:Fever / Q000209:etiology; D005374:Filtration; D006801:Humans; D006967:Hypersensitivity; D007937:Leukapheresis; D017713:Platelet Transfusion / Q000009:adverse effects*; D012306:Risk; D013997:Time Factors; D065227:Transfusion Reaction