Leukoreduced blood components: Advantages and strategies for its implementation in developing countries

Abstract

Removal of leucocytes from various blood products has been shown to minimize Febrile nonhemolytic transfusion reactions, HLA alloimmunization, platelet refractoriness in multitransfused patients and prevention of transmission of leukotropic viruses such as EBV and CMV. Rapidly growing size of hemato-oncological patients in our country requiring multiple transfusion of blood and components during the course of their management pose a great challenge to transfusion services to provide them red cell and platelet antigen matched products in alloimmunized subjects. Thus removal of leucocytes below a certain threshold, ≤ 5 × 106 in a blood component certainly helps in prevention of alloimmunization and associated risks in these patients. Currently the best Leucoreduction can be achieved with the help of 3rd and 4th generation leukofilters, both in laboratory and patient bed side, and state of the art apheresis devices. The present article briefly reviews the current literature for pros and cons of leucofilteration and its scope of implementation in the cost constrained settings.

Aged Human Stored Red Blood Cell Supernatant Inhibits Macrophage Phagocytosis in an HMGB1 Dependent Manner After Trauma in a Murine Model

“…The volume of RBC supernatant was chosen to best model a murine ‘massive transfusion.’ The acellular supernatant fraction was chosen as this was the fraction most likely to contain soluble HMGB1, as confirmed by the absence of HMGB1 on RBCs as shown by FACS analysis. Although a smaller volume of HMGB1 was still detected in leukoreduced RBC units, this could still be from residual leukocytes, as leukoreduction techniques have been shown to leave some residual leukocyte component (<5,000,000 WBCs/unit) and/or result in leukocyte injury/death and the potential for HMGB1 release (33). Furthermore, transfusion of the acellular human supernatant minimizes issues of xenogeneic immune activation, allowing for the ability to test the effects of human HMGB1, albeit necessarily in a murine model of trauma.…”

Application of reticulated platelets to transfusion management during autologous stem cell transplantation

“…The other bag contained a mean of 3.0 (±0.2) × 10 11 PLTs, and was preserved in T-SOL at 23°C for no longer than 2 days to avoid changes of numbers over time 11. The PCs were leukodepleted by MachoPharma filters (Mouvaux, France) to avoid immunologically mediated effects, further possible bacterial contaminations, and infectious disease transmission (cytomegalovirus, human T-lymphotrophic virus Type I and II) 12–14. Finally, they were also treated by a gamma irradiator for 6 minutes, at the time of transfusion 16,17.…”

Effectiveness of buffy coat leucoreduced packed red blood cells in decreasing febrile non-hemolytic transfusion reactions in thalassemic patients

“…It is also reported to prevent the transmission of leukotropic viruses, such as cytomegalovirus, human T-cell leukemia virus, and Epstein Barr virus. 5 In view of these findings, a study was carried out to compare adverse outcomes in patients of thallassemia receiving non leucoreduced blood to those receiving leucoreduced blood.…”