WBC reduction in RBC concentrates by prestorage filtration: multicenter experience.

Pubmed ID: 11493735

Journal: Transfusion

Publication Date: Aug. 1, 2001

MeSH Terms: Humans, HIV Infections, Erythrocyte Transfusion, Time Factors, Blood Preservation, Leukocytes, Leukocyte Count, Blood Component Removal, Filtration, Temperature

Grants: N01-HB-57115, N01-HB-57116, N01-HB-57117, N01-HB-57126, N01-HB-57127, N01-HB-57118, N01-HB-57119, N01-HB-57120, N01-HB-57121, N01-HB-57122, N01-HB-57123, N01-HB-57124, N01-HB-57125

Authors: Kalish LA, Busch MP, Lee TH, Assmann SF, Gernsheimer T, Yomtovian R, Mohandas K

Cite As: Yomtovian R, Gernsheimer T, Assmann SF, Mohandas K, Lee TH, Kalish LA, Busch MP, Viral Activation Transfusion Study Group. WBC reduction in RBC concentrates by prestorage filtration: multicenter experience. Transfusion 2001 Aug;41(8):1030-6.

Studies:

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 x 10(6)), Council of Europe (EC) recommendation, the proposed FDA requirement (<1 x 10(6)), and a more stringent proposal (<5 x 10(5)) 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 < or =14 days old that had undergone prestorage (within 72 hours of collection) WBC-reduction filtration by a method devised to achieve a postfiltration WBC count of <5 x 10(6). 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 x 10(6) WBCs per unit, 8.3 percent exceeded 1 x 10(6) WBCs per unit, and 14.3 percent exceeded 5 x 10(5) 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.