Comparison of Efficacy of Prestorage with Poststorage Leukocytoreduction Filters in Transfusion Dependent Thalassemic Patients

Introduction &

Cellular blood products such as whole blood, packed RBC and platelet concentrate may contain a large number of donor leukocytes. These transfused cells are responsible for several transfusion reactions which include febrile reactions, platelet refractoriness due to alloimmunization and some cell associated virus transmission, especially cytomegalovirus. Advances in biotechnology resulted in production of filters capable of depleting residual leukocytes below the threshold receded to prevent these complications. The aim of this study was to determine the efficacy of prestorage and poststorage leukocyte reduction filters.

In this experimental study 140 leukocyte filters used in patients with major thalassemia with age range of 1 to 18 years old were studied. They received packed RBC with pre storage or post storage filtration in pediatric hematology clinic of Be’sat hospital, Hamadan,Iran. In addition to filter efficiency, some transfusion reactions such as hypotension, urticaria, flushing, fever and chills were analyzed with chi-square and independent t-test.

Calculated efficiencies of pre storage and post storage filtration were 99.70%±69% and 92.74%±12.47% respectively, which is statistically significant (P=0.000). Fever, chills, urticaria and flushing which are some transfusion reactions, were not seen in any patients received filtrated packed RBC. No transfusion complication except hypotension (which was seen in 14 patients in both groups) was seen. Maximum remained leukocyte in pre storage packed RBC was 20/mm3 and 524/mm3 in post storage blood.

According to the calculated standard deviation, pre storage leukocyte filters are superior to post storage filters, and so post storage filtration is not a reliable method to reduce remaining white blood cells in transfused blood.