Is Leukoreduction of Blood Components for Everyone?

Reduction of febrile but not allergic reactions to RBCs and platelets after conversion to universal prestorage leukoreduction

“…A study by Hebert et al 29 looked retrospectively at the effect of the implementation of ULR in Canada on high‐risk patients s/p Coronary Artery Bypass Graft CABG, hip replacement, or trauma resulting in ICU admission. His group found a decrease in episodes of fever from 24.7 to 22.5 percent (unadjusted OR, 0.88; 95% CI, 0.82‐0.95; p = 0.001), Another study by this group and a commentary provide additional data on the use of UPL in clinical practice 30,31 . Finally, the hemovigilance network in France reported a 41‐percent decrease in FNHTR (p < 0.001, n > 3 × 10 6 RBC units) 32 .…”

Can Policy Decisions in Transfusion Medicine Be Evidence‐Based?*

“…However, the two Canadian studies 29,30 could not attribute any improved outcomes observed post-universal WBC reduction to the introduction of the intervention per se. 31 In fact, other observational, before-and-after studies that made similar comparisons between patients transfused before or after implementation of universal WBC reduction in France 32 or England 33 reached different conclusions, and the findings of Hébert et al 29 and Fergusson et al 30 contrast sharply with the results of the RCT of Dzik et al 34 that assessed the benefits of universal WBC reduction in a prospective and experimental manner. Thus, the two Canadian studies 29,30 generated evidence of no harm that is valuable for countries that have already implemented universal WBC reduction.…”

“…They could not, however, produce evidence of benefit of a nature suitable for influencing the policy-making process in countries that have not introduced universal WBC reduction. 31 Was the application of the precautionary principle, which led to the introduction of universal WBC reduction in 1998-1999 in Canada, justified? Did the evidence of no harm provided later 29,30 vindicate the use of the precautionary principle in 1998-1999?…”

Leucorreducción Universal en Costa Rica: ¿Es realmente urgente?

“…En los casos adversos documentados, más del 90% de las reacciones transfusionales están asociadas a la administración de leucocitos [4,5]. La exposición a los leucocitos alogénicos en las transfusiones puede desencadenar respuesta del sistema inmunitario en el receptor, lo que conlleva un mayor riesgo de infección, una recurrencia más temprana de malignidad y una mayor probabilidad de mortalidad [6].…”