Leucocyte depleted blood.

Abstract

Non-haemolytic febrile transfusion reactions (NHFTR) are commonly associated with the production of leucocyte antibodies, especially in multitransfused patients. These reactions can be prevented or ameliorated by the transfusion of leucocyte depleted red cells. Manual centrifugation techniques are least effective and risk the loss of excessive red cells. Saline washing can be effective, but is either tedious (manual techniques) or results in slight excess red cell losses (machine techniques). Sedimentation with high molecular weight polymers such as dextran produce excellent leucocyte depletion and small red cell losses. Filtration is both relatively straightforward and relatively cheap, and results in very effective red cell depletion with acceptable red cell losses. Microaggregate filtration is an alternative low cost bedside technique whose effectiveness does not depend entirely on maximum total leucocyte depletion. Freezing and thawing of red cells is very effective but is costly. Whatever technique is chosen, leucocyte depletion of at least 80% should be aimed for. The final choice however will depend on factors such as available facilities, experience and expense, and additional clinical factors such as the requirements for platelet depletion and plasma removal.