The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC
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...
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| Published in: | Transfusion (Philadelphia, Pa.) Vol. 44; no. 1; pp. 10 - 15 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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Oxford, UK and Malden, USA
Blackwell Science Inc
01-01-2004
Blackwell Publishing |
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| Abstract | 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. |
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| AbstractList | BACKGROUNDFebrile 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 METHODSA 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.RESULTSIn 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 significantly reduced.CONCLUSIONPrestorage WBC reduction significantly reduced the rate of FNHTRs to PCs and RBCs. 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. 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. 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. 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. 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 significantly reduced. Prestorage WBC reduction significantly reduced the rate of FNHTRs to PCs and RBCs. |
| Author | Yazer, Mark H. Podlosky, Linda Nahirniak, Susan M. Clarke, Gwen |
| Author_xml | – sequence: 1 givenname: Mark H. surname: Yazer fullname: Yazer, Mark H. email: myazer@ualberta.ca organization: From the Department of Laboratory Medicine and Pathology, University of Alberta; and Capital Health Transfusion Service, Edmonton, Alberta, Canada.Mark Yazer, MD, 4B1.34 Walter Mackenzie Health Sciences Center, 8440-112 Street, Edmonton Alberta T6G 2B7 Canada; e-mail – sequence: 2 givenname: Linda surname: Podlosky fullname: Podlosky, Linda email: myazer@ualberta.ca organization: From the Department of Laboratory Medicine and Pathology, University of Alberta; and Capital Health Transfusion Service, Edmonton, Alberta, Canada.Mark Yazer, MD, 4B1.34 Walter Mackenzie Health Sciences Center, 8440-112 Street, Edmonton Alberta T6G 2B7 Canada; e-mail – sequence: 3 givenname: Gwen surname: Clarke fullname: Clarke, Gwen email: myazer@ualberta.ca organization: From the Department of Laboratory Medicine and Pathology, University of Alberta; and Capital Health Transfusion Service, Edmonton, Alberta, Canada.Mark Yazer, MD, 4B1.34 Walter Mackenzie Health Sciences Center, 8440-112 Street, Edmonton Alberta T6G 2B7 Canada; e-mail – sequence: 4 givenname: Susan M. surname: Nahirniak fullname: Nahirniak, Susan M. email: myazer@ualberta.ca organization: From the Department of Laboratory Medicine and Pathology, University of Alberta; and Capital Health Transfusion Service, Edmonton, Alberta, Canada.Mark Yazer, MD, 4B1.34 Walter Mackenzie Health Sciences Center, 8440-112 Street, Edmonton Alberta T6G 2B7 Canada; e-mail |
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| Notes | ark:/67375/WNG-F0R05GD6-R istex:2E46CB084BDF3A7214D84C130234CB82161746F6 All figures in CDN Dollars. Cost per double collection bag for RBC without filter =$6.20, quad collection bag for PC without filter =$8.54, average =$7.37. Cost per bag for both RBC and PC collections with in-line filter =$42. Average additional cost per RBC and PC collection with in-line filter =$35. Cost of prestorage WBC reduction per FNHTR prevented =[(♯ units transfused/month × average additional cost) /♯ FNHTR prevented by prestorage WBC reduction]. Collection bag costs provided by personal communication with Pall Medical, May 2003. ArticleID:TRF518 All figures in CDN Dollars. Cost per double collection bag for RBC without filter =$6.20, quad collection bag for PC without filter =$8.54, average =$7.37. Cost per bag for both RBC and PC collections with in‐line filter =$42. Average additional cost per RBC and PC collection with in‐line filter =$35. Cost of prestorage WBC reduction per FNHTR prevented =[(♯ units transfused/month × average additional cost) /♯ FNHTR prevented by prestorage WBC reduction]. Collection bag costs provided by personal communication with Pall Medical, May 2003. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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| References_xml | – volume: 11 start-page: 45 year: 2001 end-page: 7 article-title: Platelet washing to prevent febrile reactions to leucocyte‐reduced transfusions publication-title: Trans-fusion Med – volume: 42 start-page: 753 year: 2002 end-page: 8 article-title: Platelet transfusions in children: results of a randomized, prospective, cross‐over trial of plasma removal and a prospective audit of WBC reduction publication-title: Transfusion – volume: 40 start-page: 781 year: 2000 end-page: 8 article-title: Evaluation of pooled platelet concentrates using prestorage versus poststorage WBC reduction: impact of filtration timing publication-title: Transfusion – volume: 42 start-page: 1114 year: 2002 end-page: 22 article-title: A prospective, randomized clinical trial of universal WBC reduction publication-title: Transfusion – volume: 39 start-page: 231 year: 1999 end-page: 8 article-title: A randomized controlled trial comparing plasma removal with white cell reduction to prevent reactions to platelets publication-title: Transfusion – volume: 35 start-page: 117 year: 1995 end-page: 24 article-title: Effect of filtration of platelet concentrates on the accumulation of cytokines and platelet release factors during storage publication-title: Transfusion – volume: 82 start-page: 156 year: 2002 end-page: 60 article-title: Cytokine release in febrile non‐haemolytic red cell transfusion reactions publication-title: Vox Sang – volume: 36 start-page: 21 year: 1996 end-page: 8 article-title: Charac‐terization of reactions after transfusion of cellular blood components that are white cell reduced before storage publication-title: Transfusion – year: 2002 – volume: 42 start-page: 318 year: 1982 end-page: 21 article-title: Febrile transfusion reaction: what blood component should be given next? 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| Snippet | BACKGROUND: Febrile non‐hemolytic transfusion reactions (FNHTRs) are a common complication of platelet concentrate (PC) and RBC transfusions, usually ascribed... Febrile non-hemolytic transfusion reactions (FNHTRs) are a common complication of platelet concentrate (PC) and RBC transfusions, usually ascribed to cytokines... BACKGROUND: Febrile non‐hemolytic transfusion reactions (FNHTRs) are a common complication of platelet concentrate (PC) and RBC transfusions, usually ascribed... BACKGROUNDFebrile non-hemolytic transfusion reactions (FNHTRs) are a common complication of platelet concentrate (PC) and RBC transfusions, usually ascribed to... |
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| SubjectTerms | 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 |
| Title | The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC |
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