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Laboratory and clinical comparison of the efficacy of prestorage leukoreduction of red cells at cold versus room temperature
Author(s) -
Mittal Siddharth,
Chacko Mary Purna,
Varughese Santosh,
Raj Amal,
Gowri Mahasampath,
Thankachen Roy,
Mammen Joy,
Daniel Dolly
Publication year - 2021
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.16570
Subject(s) - leukoreduction , medicine , incidence (geometry) , red cell , red blood cell , anesthesia , surgery , blood transfusion , physics , optics
Background The temperature at which filtration takes place has been reported to influence the efficacy of leukoreduction. We aimed to compare the residual leukocyte count (RLC) in red cell units (RCUs) filtered at cold (CT) versus room temperature (RT) and to assess whether this correlates clinically with a difference in the incidence of acute transfusion reactions (ATRs). Methods and materials In the first part of the study, whole blood units collected were randomly allocated for subsequent filtration at CT and RT, respectively. RLC postfiltration was assessed using flow cytometry. The second part of the study was a nonrandomized clinical trial in which incidence of ATR was compared between RCUs filtered at RT and CT for 6 months each. Results Thirty‐five RCUs each underwent leukofiltration at CT and RT, respectively. The median RLCs in the filtered units at CT and RT were 0.02 × 10 6 and 0.1 × 10 6 leukocytes/unit, respectively ( p = .0001), with no difference in red blood cell ( RBC) recovery ( p = .41). During the second part, 3455 RCUs filtered at RT and 3539 RCUs filtered at CT were transfused to patients. The rate of febrile non‐hemolytic transfusion reaction (FNHTR) among transfused patients was less with units filtered at CT (1 per 2000 transfusions) in comparison to RT (1 per 588 transfusions). The difference was, however, not significant ( p = .14). Conclusion If change in temperature alone can cause significant reduction in leukocytes, then it is a simple way to curtail the rate of this common yet unpleasant reaction and reduce the reaction rate at minimal cost.