WBC reduction in RBC concentrates by prestorage filtration: Multicenter experience

Roslyn Yomtovian, Terry Gernsheimer, Susan F. Assmann, Kala Mohandas, Tzong Hae Lee, Leslie A. Kalish, Michael P. Busch

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

BACKGROUND: As universal leukocyte (WBC) reduction (ULR) is being considered as a new standard, few data are available on the performance of WBC-reduction filtration in routine practice. The performance of WBC-reduction in RBCs, using varied filtration practices, in meeting the current FDA requirement (<5 × 106). Council of Europe (EC) recommendation, the proposed FDA requirement (<1 × 106), and a more stringent proposal (<5 × 105) for residual WBCs per RBC unit was assessed and compared. STUDY DESIGN AND METHODS: Participating facilities were the 11 sites of the Viral Activation Transfusion Study (VATS), a prospective study of the impact of transfusion with and without WBC-reduction on survival and HIV viral load in HIV-1-infected patients. Patients randomly assigned to undergo WBC reduction were required to receive RBCs <14 days old that had undergone prestorage (within 72 hours of collection) WBC-reduction filtration by a method devised to achieve a postf iltration WBC count of <5 × 106. Residual WBC quantitation was performed by PCR in the central VATS laboratory by using frozen WBC-reduced RBC samples obtained at issue for transfusion. RESULTS: A total of 1869 WBC-reduced RBC units were studied. Filtration practices varied within and between sites. There were significant differences in mean residual WBC counts at the 11 sites (p<0.001). Among the WBC-reduced RBC units, 0.8 percent exceeded 5 × 106 WBCs per unit, 8.3 percent exceeded 1 × 106 WBCs per unit, and 14.3 percent exceeded 5 × 105 WBCs per unit. CONCLUSION: Residual WBCs in WBC-reduced RBC units vary within and between sites. WBC reduction was successful, in that over 99 percent and 91 percent of VATS WBC-reduced RBC units met US and EC thresholds, respectively. However, the small but measurable failure rate indicates that not every unit will meet these guidelines.

Original languageEnglish (US)
Pages (from-to)1030-1036
Number of pages7
JournalTransfusion
Volume41
Issue number8
DOIs
StatePublished - Aug 1 2001
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

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