Is there justification for universal leukoreduction?

Mendrone, Alfredo; Fabron, Antonio; Langhi, Dante Mário; Covas, Dimas Tadeu; Dinardo, Carla Luana; Ubiali, Eugênia Amorim; Marques, José Francisco Comenalli; Bordin, José Orlando; Rugani, Marilia

doi:10.1016/j.bjhh.2014.06.004

Cited by 7 publications

(4 citation statements)

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“…Accumulating evidence has shown that leukoreduction of blood components plays an essential role in decreasing the rate of TAARs and postoperative infection in the transfusion [ 4 , 13 – 18 ]. Though it remains controversial [ 19 ], universal leukocyte reduction in blood components has been implemented as part of blood safety policy in some economically developed countries [ 20 ]. It was observed that transfusion of RBCs and platelet concentrates (PCs) with prestorage leukoreduction greatly reduced the FNHTR rate instead of the rate of allergy reactions [ 4 , 13 , 14 ], partially consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Chang

Lee

et al. 2017

Oncotarget

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Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, in vitro evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.

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Section: Discussionmentioning

confidence: 99%

Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Chang

Lee

et al. 2017

Oncotarget

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“…154 As a result of the limited evidence, the rationale for applying universal leukodepletion remains highly debated by the scientific community. 155,156 Unfortunately, this debate is not likely to be resolved, as universal leukodepletion has become the standard of care in most Western countries.…”

Section: Recommendationmentioning

confidence: 99%

Management of severe perioperative bleeding

Kozek‐Langenecker

Ahmed

Afshari

et al. 2017

European Journal of Anaesthesiology

655

315

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: The management of perioperative bleeding involves multiple assessments and strategies to ensure appropriate patient care. Initially, it is important to identify those patients with an increased risk of perioperative bleeding. Next, strategies should be employed to correct preoperative anaemia and to stabilise macrocirculation and microcirculation to optimise the patient's tolerance to bleeding. Finally, targeted interventions should be used to reduce intraoperative and postoperative bleeding, and so prevent subsequent morbidity and mortality. The objective of these updated guidelines is to provide healthcare professionals with an overview of the most recent evidence to help ensure improved clinical management of patients. For this update, electronic databases were searched without language restrictions from 2011 or 2012 (depending on the search) until 2015. These searches produced 18 334 articles. All articles were assessed and the existing 2013 guidelines were revised to take account of new evidence. This update includes revisions to existing recommendations with respect to the wording, or changes in the grade of recommendation, and also the addition of new recommendations. The final draft guideline was posted on the European Society of Anaesthesiology website for four weeks for review. All comments were collated and the guidelines were amended as appropriate. This publication reflects the output of this work.

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“…Other studies demonstrated that leukoreduced blood products, although safer, still carry a theoretical risk of HTLV‐1 transmission from donors with high proviral load [45]. Thus, in countries with a high prevalence of HTLV, like Argentina and Brazil [46], where universal leukoreduction is not recommended, it is important to be aware of any residual risk for HTLV transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, in countries with a high prevalence of HTLV, like Argentina and Brazil [46], where universal leukoreduction is not recommended, it is important to be aware of any residual risk for HTLV transmission.…”

Section: Discussionmentioning

confidence: 99%

Seronegative human T‐cell lymphotropic virus 1 carriers in blood banks: A potential viral source for silent transmission?

et al. 2022

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Background and Objectives: Transfusion-transmitted viruses count among the greatest threats to blood safety. In Argentina, current laws oblige testing all donated blood for the presence of antibodies against human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2). In endemic zones of the country, a high rate of seronegative HTLV-1 individuals with clear evidence of infection because of symptoms and/or presence of tax sequences of HTLV-1 and/or IgG anti-Tax antibodies has been recently described. Migration from endemic to nonendemic zones of Argentina is very frequent. Materials and Methods:During a 1-year period, in the blood bank of C ordoba city, we performed molecular screening of all donors who were born in or arose from endemic zones for HTLV-1/2 in Argentina and neighbouring countries.Results: By screening 219 bp of HTLV-1/2 tax gene, 0.6% (2/317) of the blood donors proved to be positive for HTLV-1 tax sequence. One of the donors presented anti-Tax antibodies, demonstrating the transcriptional activity of the tax gene, and the other donor was also positive for LTR and pol gene sequences. The HTLV-1 genetic analysis of the LTR sequence determined that it belonged to the Cosmopolitan subtype HTLV-1aA.Conclusion: These findings suggest potential limitations of some currently approved screening assays for HTLV-1 detection applied in some donor populations and the possibility of an HTLV-1 seronegative carrier state with the potential for silent transmission by blood.

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Is there justification for universal leukoreduction?

Cited by 7 publications

References 0 publications

Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Management of severe perioperative bleeding

Seronegative human T‐cell lymphotropic virus 1 carriers in blood banks: A potential viral source for silent transmission?

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