The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC

• Published in: Transfusion (Philadelphia, Pa.) Vol. 44; no. 1; pp. 10 - 15
• Main Authors: Yazer, Mark H., Podlosky, Linda, Clarke, Gwen, Nahirniak, Susan M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK and Malden, USA Blackwell Science Inc 01-01-2004; Blackwell Publishing
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Preservation; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Erythrocyte Transfusion - adverse effects; Fever - epidemiology; Fever - etiology; Fever - prevention & control; Humans; Incidence; Leukapheresis; Medical sciences; Platelet Transfusion - adverse effects; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Platelet; Transfusion; Concentrate; Fever
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1046/j.0041-1132.2003.00518.x

BACKGROUND:  Febrile non‐hemolytic transfusion reactions (FNHTRs) are a common complication of platelet concentrate (PC) and RBC transfusions, usually ascribed to cytokines released by WBCs and perhaps the platelets themselves during storage. Prestorage WBC reduction should abrogate the accumulation of these cytokines reducing the number of FNHTRs.
STUDY DESIGN AND METHODS:  A retrospective analysis of FNHTR to PCs and RBCs before universal WBC reduction (PrUR) (July 1997‐January 1998 for PCs, July 1997‐July 1999 for RBCs) and after its introduction (PoUR) (February 1998‐August 2001 for PC, August 1999‐August 2001 for RBCs) was undertaken. All transfusion reactions were stratified based on component and date of reaction. Other adverse transfusion reactions were grouped into three periods: July 1997‐January 1998, February 1998‐July 1999, and August 1999‐August 2001. A chi‐square test was performed to determine the significance of the differences between groups.
RESULTS:  In the PrUR group, there were 231 FNHTRs in 70,396 RBC units transfused (0.33%) and 29 FNHTRs in 6502 PC units transfused (0.45% percent). In the PoUR group, there were 136 FNHTRs in 72,949 RBC units transfused (0.19%, p < 0.001) and 56 FNHTRs in 50,555 PC units transfused (0.11%, p < 0.001). Of the other adverse events, only TRALI reactions were sig‐nificantly reduced.
CONCLUSION:  Prestorage WBC reduction significantly reduced the rate of FNHTRs to PCs and RBCs.