LEUKOREDUCTION - CURRENT STATE-OF-THE-ART

The proportion of the world's blood supply which is leukoreduced conti nues to increase each year. In the United States approximately 25-30% of red cell concentrates are currently leukoreduced. The bulk of these are leukoreduced using bedside filters, but increasingly the technolo gy for leukocyte reduction is moving from bedside filtration towards f iltration in the laboratory. Laboratory filtration offers distinct adv antages of quality process control. Important: technical variables - s uch as temperature of the blood at the time of filtration can be contr olled with laboratory-based leukoreduction. Leukoreduced blood has bee n proven to decrease the incidence of primary HLA alloimmunization, to prevent febrile nonhemolytic reactions to red cells! and to prevent t ransmission of CMV. Prevention of febrile reactions to platelet concen trates is best done with prestorage leukoreduction. There is growing e vidence that the use of leukoreduced blood will prevent whatever degre e of immunosuppression may accompany routine allogeneic blood transfus ions. Whether or not leukoreduction has any impact on the potential fo r transmission of prion-based diseases by transfusion is currently unk nown.