Prestorage leukocyte filtration may reduce leukocyte-derived bioactive substance accumulation in patients operated for burn trauma

Transfusion-related mortality: the ongoing risks of allogeneic blood transfusion and the available strategies for their prevention

“…13-15,45-52 Across 5 RCTs conducted in cardiac surgery [13][14][15]49,51 that had transfused RBCs filtered before storage to the WBC-reduced arm, non-WBC-reduced (vs WBCreduced) ABT was associated with a 72% increase in postoperative mortality ( Figure 4A). In contrast, across 6 RCTs conducted in other settings, [45][46][47][48]50,52 non-WBC-reduced (vs WBC-reduced) ABT was not associated with any increase in postoperative mortality ( Figure 4B). 53 The adverse effect selectively seen across the open heart surgery studies [13][14][15]49,51 may be associated with factors prevalent in patients undergoing cardiac surgery.…”

“…Postoperative mortality in cardiac surgery versus other surgical settings, as calculated from randomized controlled trials investigating the association of nonwhite blood cell-reduced ABT with short-term (up to 3 months after transfusion) mortality from all causes. [13][14][15][45][46][47][48][49][50][51][52] The figure shows the odds ratio (OR) of mortality in recipients of nonwhite blood cell-reduced versus white blood cell (WBC)-reduced allogeneic RBCs, as calculated from each randomized controlled trial (RCT), across RCTs conducted in cardiac surgery (A) 13 12 The number of vCJD cases worldwide has barely exceeded 200, of which 167 have occurred in the United Kingdom. 68 The incidence appears to be falling, and recent mathematical projections have suggested an upper limit of approximately 70 further clinical cases in the United Kingdom, 69 or that 3800 people aged 10 to 30 years (1 per 11 000 in the United Kingdom population) may be incubating the disease.…”

Clinical Impact of Bioactive Substances in Blood Components: Implications for Leukocyte Filtration

“…All transfusions were given via a blood-heating device increasing the blood temperature to 37 °C. Intraoperative patient plasma accumulation of bioactive substances, in particular MPO and ECP, was significantly reduced in patients receiving leukofiltered components compared with patients receiving nonfiltered components [138]. Active heating, in particular of nonfiltered components, played a minor role compared with prestorage leukofiltration [138].…”

Cardiac Surgery and Allogeneic Blood Transfusions

“…Few studies investigated the possible mechanisms of allogeneic leukocyte-containing blood products on the cytokine balance. One a small study in 24 burn trauma patients showed an increase in IL-6 in patients receiving leukocyte-containing RBC transfusions (Nielsen et al, 1999). A larger study found in 114 patients an association after cardiac surgery between peri-operative allogeneic RBC transfusions and postoperative increase of concentrations of the inflammatory mediators bactericidal permeability increasing protein (BPI), as a marker of neutrophil activation, and IL-6 (Fransen et al, 1999).…”