Universal leukodepletion of blood components results in a significant reduction of febrile non-hemolytic but not allergic transfusion reactions

Pruss, Axel; Kalus, Ulrich; Radtke, Hartmut; Koscielny, Jürgen; Baumann-Baretti, Bärbel; Balzer, Dominik; Dörner, Thomas; Salama, Abdulgabar; Kiesewetter, Holger

doi:10.1016/j.transci.2003.08.013

« Previous Next »Transfusion and Apheresis Science
Volume 30, Issue 1 , Pages 41-46, February 2004

Universal leukodepletion of blood components results in a significant reduction of febrile non-hemolytic but not allergic transfusion reactions

Axel Pruss
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
- Corresponding author. Tel.: +49-30-450-525161; fax: +49-30-450-525976
Ulrich Kalus
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Hartmut Radtke
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Jürgen Koscielny
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Bärbel Baumann-Baretti
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Dominik Balzer
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Thomas Dörner
- Department of Medicine, Rheumatology and Clinical Immunology, University Hospital Charité, Humboldt University, D-10098 Berlin, Germany
Abdulgabar Salama
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany
Holger Kiesewetter
- Institute for Transfusion Medicine (Tissue Bank), University Hospital Charité, Campus Charité Mitte, Schumannstrasse 20/21, D-10117 Berlin, Germany

Received 1 November 2002; accepted 1 August 2003.

Abstract

Background. Universal leukodepletion of blood components to prevent acute non-hemolytic transfusion reactions (NHTRs) is still a subject of debate.

Patients and 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%).

Conclusion. 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.

Keywords: Febrile non-hemolytic transfusion reaction (FNHTR), Hemovigilance, Leukodepletion, Transfusion reactions, Transfusion risks