Leukocyte depletion for safe blood transfusion

Abstract

Leukocytes have ability to distinguish between self cells (body own cells) and foreign (allogenic) cells on the basis of human leukocyte antigen (HLA) proteins that are present on the cell membrane and are effectively unique to a person. During allogenic blood transfusion a person receives large number of allogenic donor leukocytes and these are recognized as foreign cells by the recipient immune system which leads to several adverse reactions. To avoid such leukocyte-mediated adverse reactions leukodepleted blood transfusion is required. Leukocytes can be separated on the basis of size, dielectric properties, by affinity separation, freeze-thawing and centrifugation but all these methods are time consuming and costly. Filtration is another method for leukocyte depletion that is comparatively less expensive and more efficient as it gives more than 90% leukodepletion of blood along with minimal cell loss. However, present filtration procedures also have some limitations as they work efficiently with blood components but not with whole blood and show non-specific adhesion of large number of platelets and red blood cells along with leukocytes. All the currently available filters are costly, which has been a major reason for their limited application. Therefore, demand for a more efficient and cost-effective filter is high in medical community and scientists are attenpting to improve the efficiency of currently available filters. The present review gives an overview of the significance of leukodepleted blood transfusion and focuses on different methods for leukocyte depletion and challenges involved in all these technologies.

Biochemical and Cellular Changes in Leukocyte-Depleted Red Blood Cells Stored for Transfusion

“…These changes have already been described by Bosman et al [5], and seem to result from a deregulated mechanism of cell volume, which explains the increase in the volume of the RBCs, the increasing hypocromia, and the anisocytosis. Hence, the decrease in MCHCdoes not result from a reduction in hemoglobin concentration but from an increase in cell volume [5,12,13]. The transport of Na + and K + through the RBC membrane is also related to cell volume.…”

Functionalization of nickel nanowires with a fluorophore aiming at new probes for multimodal bioanalysis

“…In some situations, such as in blood transfusion, it is necessary to reduce the concentration of leukocytes in blood, in order to prevent leukocyte-mediated adverse effects [51,54,55]. Therefore, the materials described here may contribute to develop additional tools for the depletion of leukocytes, taking advantage of the ferromagnetic properties of nickel nanowires.…”

Effect of leukocyte filtration on the P-selectin expression of apheresis platelets

“…Owing to the low leukocyte count remaining in the apheresis platelets (approximately 10 6 to 10 8 ), as well as the consideration that leukocyte filtration may disrupt platelet activation, leukocyte filtration has not been widely used for apheresis platelets. With increasing reports on platelet transfusion refractoriness, the necessity of leukocyte filtration has recently attracted considerable attention (McGettrick et al, 2007;Boodram and Evans, 2008;Singh and Kumar, 2009;Miyaji et al, 2010). Clinical evaluation of the performance of the platelet-specific leukocyte filter merely includes leukocyte removal rate, platelet recoveries, and other indicators (Alaoja et al, 2006;Ott et al, 2006).…”