Leukocyte depletion of red cell units at the bedside by transfusion through a new filter

Abstract

Standard packed red cell (PRC) units can be depleted of leukocytes and platelets if they are transfused through a blood administration set in which the usual 170-mu filter has been replaced by a leukocyte removal filter (Sepacell R-500). During a 6-month period, 1550 PRC units were transfused through this filter in 611 transfusions to 80 multitransfused patients with thalassemia who had had a patient reaction rate (PRR) of 63 percent and a transfusion reaction rate (TRR) of 13 percent when given standard PRC or buffy-coat-depleted PRC. When given filtered PRC, PRR and TRR became 3.7 percent and 0.5 percent, respectively. The effectiveness of the filter was also evaluated in vitro. By filtering 2 standard PRC units through the same filter, median values (and ranges) for red cell recovery and for residual leukocytes and platelets were 87 percent (83-92), 6.1 X 10(6) (0-100), and 2.7 X 10(9) (0.6-9.7), respectively. Although refinements are needed to improve standardization of the filter and to increase red cell recovery (which is low when 1 unit is filtered through one filter) and blood administration rate, the ability to provide leukocyte-free red cells prepared at the bedside for virtually all recipients appears to be a realistic goal.

Possibility to Improve Preservation of Whole Blood by Leukocyte-Depletion before Storage

“…Aiming at the prevention human lymphocyte antigens (HLA) sensitization [4,7,13], virus transmission and other advantages of leukocyte depletion of whole blood [13], several techniques have been developed and compared [1,6,11,12,14,17]. Most recently, a practicable and highly effective bedside filter has been developed and tested [3,5,9,16].…”

“…Hence, the re moval of leukocytes and platelets might contribute to bet ter storage conditions. Recently, several methods for leu kocyte removal have been investigated, including sedimen tation and centrifugation procedures [11,12,17], For bedside purposes, a filter procedure with an adhesion filter proved most useful [3,5,9,14,16]. In this study, we used this filter system to remove leukocytes prior to long-term storage.…”

Effects of blood transfusion with leucocyte depletion on length of hospital stay, respiratory assistance and survival after curative surgery for colorectal cancer

“…This is a highly effective filter which results in 3 log 10 leucocyte reduction [10] and has been reported to be effective for two units of whole blood or red cells [11]. Each filter was used for a maximum of two units of buffy-coat removed red cell concentrates or two units of plasma.…”

Leukocyte-Poor Platelet Concentrates at the Bedside by Filtration through Sepacell-PL

“…To prevent posttransfusion complications such as non hemolytic febrile reactions and antileukocyte antibody for mation, leukocytes may need to be removed from blood products for transfusion [1][2][3]. Leukocyte-poor red cells for transfusion can be prepared by centrifugation and washing, or by filtration.…”