Leukoreduction for the prevention of adverse reactions from allogeneic blood transfusion

Abstract

BackgroundA blood transfusion is an acute intervention, implemented to solve life and health-threatening conditions on a short-term basis. However, blood transfusions have adverse events, some of them potentially related to immune modulation or to a direct transmission of infectious agents (e.g. cytomegalovirus). Leukoreduction is a process in which the white blood cells are intentionally reduced in packed red blood cells (PRBCs) in order to reduce the risk of adverse reactions. The potential benefits of leukoreduced PRBCs in all types of transfused patients for decreasing infectious and non-infectious complications remain unclear. ObjectivesTo determine the clinical effectiveness of leukoreduction of packed red blood cells for preventing adverse reactions following allogeneic blood transfusion. Search methodsWe ran the most recent search on 10th November 2015. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), MEDLINE (OvidSP), Embase(OvidSP), CINAHL Plus (EBSCO), LILACS (BIREME), and clinical trials registers. In addition, we checked the reference lists of all relevant trials and reviews identified in the literature searches. Selection criteriaRandomised clinical trials including patients of all ages requiring PRBC allogeneic transfusion. Any study was eligible for inclusion, regardless of the length of participant follow-up or country where the study was performed. The primary outcome was transfusion-related acute lung injury (TRALI). Secondary outcomes were death from any cause, infection from any cause, non-infectious complications and any other adverse event.1 Leukoreduction for the prevention of adverse reactions from allogeneic blood transfusion (Review)

Blood transfusion service in Poland in 2018

“…As mentioned above, leukocyte-depleted PCs account for about 90.64% of all PCs obtained country-wide. In many countries regular/common leuko-depletion is currently used although its effectiveness in preventing transfusion-related adverse reactions is sometimes questioned [28].…”

Impact of prestorage leucoreduction of autologous whole blood on length of hospital stay with a subgroup analysis in bilateral hip arthroplasty

“…However, the role of LR in preventing postoperative infections and thrombosis has been debated. A Cochrane Database meta‐analysis performed in 2015 demonstrated that LR, compared to non‐LR, did not offer a clear benefit to the recipients of allogeneic RBC transfusion in terms of infection from any cause (relative risk (RR) 0·82, 95% CI: 0·62–1·03), fever (RR 0·81, 95%CI: 0·64–1·02) and mortality (RR 0·81, 95% CI: 0·58–1·12) . Two other meta‐analyses reached different conclusions.…”

Guía de Cuidados de enfermería para la administración de la sangre y sus componentes. (Revisión Integrativa)

“…Se debe revisar la prescripción médica en el expediente antes de iniciar la administración del componente sanguíneo, actividad que reduce el riesgo de errores desde la primera etapa del proceso en la identificación del receptor. De igual forma, se debe verificar si la prescripción considera alguna indicación especial (irradiación o filtrado) con la finalidad de reducir la presencia de agentes que provoquen reacciones adversas según la condición clínica e historia transfusional del usuario, a lo que se agrega que revisar la identificación del receptor reduce el riesgo de errores desde la primera etapa del proceso [2][3][4][5][6][8][9][10][11]14,16,[18][19][20][21][23][24][25][26][27] .…”