Universal WBC reduction

Thurer, Robert L.; Luban, Naomi L.C.; AuBuchon, James P.; Silver, Herbert; McCarthy, Leo J.; Dzik, Sunny; Stowell, Christopher P.; Moore, S. Breanndan; Vamvakas, Eleftherios C.; Armstrong, Will J.; Kanter, Michael H.; Jeter, Elaine K.; Becker, Joanne; Higgins, Martha; Galel, Susan A.; Kleinman, Steven; Marshall, Carol Sue; Newman, Richard D.; Ocariz, Jose; Blackall, Douglas P.; Petz, Lawrence D.; Toy, Pearl; Oberman, Harold A.; Siegel, Don L.; Price, Thomas H.; Slichter, Sherrill J.; Gernsheimer, Terry; Mintz, Paul D.; Goodnough, Lawrence T.; Lipford, Edward H.; Simpson, Marcus B.

doi:10.1046/j.1537-2995.2000.40060751.x

Cited by 46 publications

(31 citation statements)

References 1 publication

(2 reference statements)

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“…44 -46 However, despite this evidence, there has been strong opposition by some physicians from academic blood banks against the Food and Drug Administration's proposed plan for a universal leukocyte reduction mandate due to the high medical costs of leukoreduction. 47 As a result, policies regarding white blood cell reduction remain at the institutional level. Furthermore, there is some evidence to suggest that other non-leukocyte mechanisms may also be involved in the development of TRIM.…”

Section: Discussionmentioning

confidence: 99%

Significant Variation in Blood Transfusion Practice Persists following Upper GI Cancer Resection

Aquina

Blumberg

Probst

et al. 2015

Journal of Gastrointestinal Surgery

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Significant variation in perioperative blood transfusion utilization is present at both the surgeon and hospital level. These findings are unexplained by patient-level factors and other known hospital characteristics, suggesting that variation is due to provider preferences and/or lack of standardized transfusion protocols. Implementing institutional transfusion guidelines is necessary to limit unwarranted variation and reduce infectious complication rates.

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Section: Discussionmentioning

confidence: 99%

Significant Variation in Blood Transfusion Practice Persists following Upper GI Cancer Resection

Aquina

Blumberg

Probst

et al. 2015

Journal of Gastrointestinal Surgery

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“…53 In a letter to the editor of Transfusion, 53 they stated that "It is our view that published reports fail to document a substantial health benefit that would serve to justify WBC reduction of cellular blood components transfused to all patients. Accordingly, we feel that the currently available evidence regarding the deleterious effects of allogeneic blood transfusion is not sufficiently compelling to warrant universal WBC reduction for the prevention of these effects."…”

mentioning

confidence: 99%

Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?

Vamvakas

Blajchman

2001

Blood

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386

272

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“…Therefore, the practice of universal leukocyte reduction has been questioned; it has not been adopted worldwide and it varies significantly among countries, taking into consideration economic factors as well [63–65]. Particularly in North America, a strong opposition against universal leukocyte reduction has been expressed by a large group of American blood bank physicians [66]. Prospective randomized studies could give some solid answers regarding the undoubtful benefit of leukodepletion, but these studies could be performed only in countries where the practice is not mandatory.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

Theodoraki

Markatou

Rizos

et al. 2014

Journal of Immunology Research

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Blood transfusion is associated with well-known risks. We investigated the difference between a restrictive versus a liberal transfusion strategy on the immune response, as expressed by the production of inflammatory mediators, in patients subjected to major abdominal surgery procedures. Fifty-eight patients undergoing major abdominal surgery were randomized preoperatively to either a restrictive transfusion protocol or a liberal transfusion protocol (with transfusion if hemoglobin dropped below 7.7 g dL−1 or 9.9 g dL−1, respectively). In a subgroup of 20 patients randomly selected from the original allocation groups, blood was sampled for measurement of IL-6, IL-10, and TNFα. Postoperative levels of IL-10 were higher in the liberal transfusion group on the first postoperative day (49.82 ± 29.07 vs. 15.83 ± 13.22 pg mL−1, P < 0.05). Peak postoperative IL-10 levels correlated with the units of blood transfused as well as the mean duration of storage and the storage time of the oldest unit transfused (r 2 = 0.38, P = 0.032, r 2 = 0.52, P = 0.007, and r 2 = 0.68, P<0.001, respectively). IL-10 levels were elevated in patients with a more liberal red blood cell transfusion strategy. The strength of the association between anti-inflammatory IL-10 and transfusion variables indicates that IL-10 may be an important factor in transfusion-associated immunomodulation. This trial is registered under ClinicalTrials.gov Identifier: NCT02020525.

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Universal WBC reduction

Cited by 46 publications

References 1 publication

Significant Variation in Blood Transfusion Practice Persists following Upper GI Cancer Resection

Significant Variation in Blood Transfusion Practice Persists following Upper GI Cancer Resection

Deleterious clinical effects of transfusion-associated immunomodulation: fact or fiction?

The Impact of Two Different Transfusion Strategies on Patient Immune Response during Major Abdominal Surgery: A Preliminary Report

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