The reintroduction of nonleukoreduced blood: would patients and clinicians agree?

Leukoreduction filters: Still stuck on sickle trait red cells

“…A 2019 survey showed that ~97% of all collected cellular products were leukoreduced and almost 84% of U.S. hospitals have policies in place to transfuse only leukoreduced blood components 23 . Decades of experience with near‐universal leukoreduction make it unlikely that non‐leukoreduced products will ever return for anything but niche use (e.g., low‐titer group O WB) 24 …”

“…23 Decades of experience with near-universal leukoreduction make it unlikely that non-leukoreduced products will ever return for anything but niche use (e.g., low-titer group O WB). 24 LR filters remove WBCs from WB or RBC concentrates in several ways, intentionally minimizing RBC loss. Hydrostatic pressure pushes blood elements through third and fourth-generation LRFs containing packed, nonwoven webs of synthetic polymer microfibers that mechanically sieve larger, less deformable cells and aggregates.…”

In reply

“…In our experience, salvage and return of unwashed (USB) or washed (WSB) blood from postoperative drainage has demonstrated to reduce ABT requirements in these patients. 1,2 However, some authors have questioned the quality and safety of USB and suggest that shed blood must be washed before return. In this regard, we read with interest the study by Ley and colleagues, recently published in TRANSFUSION, 3 comparing the characteristics of red blood cells (RBCs) collected using OrthoPAT (Haemonetics Corp., Braintree, MA), an autologous blood processing device fitted with a dynamic disk separation chamber (n = 20; WSB group), with those of Suretrans (Davol, Inc., Warwick, RI), a "flipn-drip" system that returned shed blood to the patients after undergoing microaggregate filtering (n = 20; USB group).…”

Leukoreduced blood and sensitization of organ transplant candidates

“…The commentary by Rosenbaum and colleagues 1 regarding the prospect of abandoning the practice of universal leukoreduction makes a forceful statement of the benefits of leukoreduction and the problems of reverting to ordering this component when clinicians feel it is indicated. However, when referring to patients who may need organ transplants, the authors state that patients exposed to blood components contaminated with white blood cells may become alloimmunized.…”