Universal WBC reduction:the case for and against

Vamvakas, Eleftherios C.; Blajchman, Morris A.

doi:10.1046/j.1537-2995.2001.41050691.x

Cited by 125 publications

(87 citation statements)

References 154 publications

(454 reference statements)

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“…The latter may result in red blood cell alloimmunization, transplant rejection, febrile reactions, and refractoriness to platelet transfusions (39). Despite mounting evidence regarding the adverse consequences of leukocyte contamination of blood products, it continues to be a matter of debate whether the evidence is compelling enough to justify the cost of universal prestorage leukoreduction of blood products (40)(41)(42)(43)(44)(45)(46)(47). Despite the debate, many European countries have already adopted universal leukoreduction of blood products.…”

Section: Effect Of Leukocyte Depletion On Risk Of Hla Sensitization Amentioning

confidence: 99%

Effect of Red Cell Transfusions on Future Kidney Transplantation

Obrador

Macdougall

2013

Clinical Journal of the American Society of Nephrology

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SummaryRed cell transfusions, erythropoiesis-stimulating agents (ESAs), and intravenous iron therapy all have a place in the treatment of anemia associated with CKD. Their relative merits and uses are subject to many clinical and nonclinical factors. New concerns associated with the use of ESA therapy make it likely that the use of blood transfusions will increase, refueling previous debates about their associated risks. Data on whether red cell transfusions increase sensitization to HLA antigens, rendering subsequent transplantation more problematic, are mainly derived from older literature. Older data suggested that women were more at risk of HLA sensitization than men, particularly those with previous multiple pregnancies, although recent U.S. Renal Data System data have challenged this. HLA sensitization prolongs the waiting time for transplantation and reduces graft survival. Leukocyte depletion of red cells does not appear to reduce the risk of HLA sensitization. This review summarizes much of the data on these issues, as well as highlighting the need for further research on the potential risks for blood transfusion in patients with CKD.

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Section: Effect Of Leukocyte Depletion On Risk Of Hla Sensitization Amentioning

confidence: 99%

Effect of Red Cell Transfusions on Future Kidney Transplantation

Obrador

Macdougall

2013

Clinical Journal of the American Society of Nephrology

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“…The effectiveness of universal prestorage LR programs is controversial and continues to be debated. 15,19,25 An additional consideration affecting the patient undergoing malignancy resection is whether allogeneic blood transfusion causes immunosuppression that contributes to an increased risk of subsequent cancer recurrence, an observation first described in 1982. 26 Impaired function of natural killer cells, decreased T cell production, alteration of T cell ratios, and defective antigen-presenting cell number and function have all been associated with transfusion of allogeneic blood and are thought to be an important contributor to TRIM.…”

Section: Perioperative Transfusion Of Allogeneic Blood Productsmentioning

confidence: 99%

Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy?

Trudeau

Waters

Chipperfield

2012

Can J Anesth/J Can Anesth

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Should intraoperative cell-salvaged blood be used in patients with suspected or known malignancy? Les cellules sanguines épargnées en peropératoire doivent-elles être réutilisées chez des patients ayant des processus malins connus ou suspectés? Abstract Purpose Intraoperative cell salvage (ICS) is used as an alternative to allogeneic blood transfusion in an attempt to avoid or minimize the risks associated with allogeneic blood. Intraoperative cell salvage is generally avoided in surgeries where malignancy is confirmed or suspected due to concern for potential metastasis or cancer recurrence. The application of post-processing methods for ICS is hypothesized to eliminate this potential risk. The purpose of this narrative review is to examine the in vitro experimental evidence as it pertains to the removal of tumour cells from ICS blood and to review the clinical studies where ICS blood has been used in patients with malignancy. Source A search of the English literature for relevant articles published from 1973 to 2012 was undertaken using

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“…105,106 A recent meta-analysis 106 These data in turn have led to the hypothesis that transfusing patients with leukoreduced blood should result in reduced morbidity and mortality compared with patients receiving nonleukoreduced transfusions. Meta-analyses of the literature have failed to identify a statistically significant effect of leukoreduction 108,109 on outcomes associated with blood transfusion. A recent study evaluating clinical outcomes following the institution of a universal pre-storage leukoreduction program in Canada noted a reduction in hospital mortality following introduction of this program.…”

Section: Infectious Risksmentioning

confidence: 99%