Prestorage Leukocyte Depletion with In‐Line Filtration of Whole Blood in Comparison with Blood Component Leukocyte Depletion

Abstract

In-line filtration of blood components appears to be an effective method to reduce white-cell-induced adverse reactions. We have investigated whether whole blood filtration (WBF), prior to component preparation, is comparable with filtration of already prepared blood components (CF), i.e. the red cell concentrate (RCC) and fresh plasma. Conventionally prepared nonfiltered blood components served as a control. No significant differences for most parameters investigated were found between leukodepleted RCCs and plasma units prepared by CF or WBF. All filtered RCCs and plasma units (CF and WBF) had white blood cell contaminations < 1 x 10(5) per unit. Platelets were reduced in all filtered components: 95% in plasma and 99% in RCCs. Fresh-frozen plasma (FFP) prepared by CF and WBF had normal amounts of factors V, VIII, von Willebrand factor and thrombin-antithrombin-III complexes, whereas platelet factor 4 (PF-4) was slightly increased in FFP prepared by WBF. RCCs and plasma units prepared from filtered whole blood (n = 20) had a significantly greater volume (RCC: 288 +/- 19 ml; plasma: 274 +/- 20 ml) than conventionally prepared (n = 20) and filtered products (RCC: 257 +/- 19 ml, plasma: 259 +/- 19 ml). For early filtration of blood components, WBF prior to component preparation seems to offer an interesting technique for obtaining a leukocyte-depleted RCC and FFP.

Liquid&ndash;Stored Red Blood Cells for Transfusion

“…Leukodepletion filters are available for either anticoagulated whole blood, in which case both white cells and platelets are removed, or for red cells and platelet concentrates where only leukocytes are removed [33, 34, 35]. The filtration of whole blood before its separation into red cells and plasma has the advantage of simplicity and high quality of both products.…”

“…Filtration of units from which buffy coat has been removed have the advantage of a smaller leukocyte load on the filter, but the disadvantage of a greater loss of red cells. An apparent current trend is an increased use of prestorage, in–line filtration [34, 35, 38, 39, 40, 41]. …”

Leukozytendepletion

“…Die hergestellten Komponenten entsprechen insbesondere hinsichtlich der Leukozytenkontamination (<1×10 6 / Einheit) und der metabolischen und biochemischen Parameter (Hämolyserate, ATP, 2,3 DPG, pH, Kalium) im wesentlichen den Präparaten, die nach Herstellung der Einzelkomponenten filtriert werden [79][80][81][82].…”

“…Es konnte gezeigt werden, daß eine Aktivierung von Gerinnungsfaktoren, die die Qualität des Plasmas beeinträchtigt, bei den untersuchten Filtersystemen und dem angewandten Verfahren nicht nachweisbar ist [79][80][81]. Desweiteren ergeben sich keine Hinweise auf einen negativen Effekt durch die Filtration, wenn diese Plasmen zur Virusinaktivierung nach dem S/D-Verfahren weiterverarbeitet werden [83].…”

Efficiency of Leukocyte Removal by Filters Made of Superfine Glass Fiber Membranes

“…On the other hand, they cause side effects such as febrile nonhemolytic reactions, HLA alloimmunization, CMV and HTLV–I infections, and graft–versus–host disease, all of which are related to the number of leukocytes in the blood transfused [1]. Of the methods for removing leukocytes, filtration has found the widest application.…”