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- Title
WBC reduction in RBC concentrates by prestorage filtration: multicenter experience.
- Authors
Yomtovian, Roslyn; Gernsheimer, Terry; Assmann, Susan F.; Mohandas, Kala; Tzong-Hae Lee; Kalish, Leslie A.; Busch, Michael P.; Yomtovian, R; Gernsheimer, T; Assmann, S F; Mohandas, K; Lee, T H; Kalish, L A; Busch, M P; Viral Activation Transfusion Study Group
- Abstract
<bold>Background: </bold>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.<bold>Study Design and Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
BLOOD transfusion; LEUCOCYTES; HIV infections
- Publication
Transfusion, 2001, Vol 41, Issue 8, p1030
- ISSN
0041-1132
- Publication type
journal article