UNIVERSAL LEUKOCYTE DEPLETION OF BLOOD COMPONENTS - CON

Objective: The objective of this study was to consider the scientific case and to estimate the costs of increasing the proportion of leucocy te-depleted blood components in the UK. Design: The current utilisatio n of leucocyte-depleted blood components in one region of the UK was c ompared with an estimate of what should be used according to British S ociety for Haematology (BSH) guidelines. Estimates were made of the co sts and potential cost savings of the use of leucocyte-depleted brood components for additional specific groups of patients up to universal leucocyte depletion of all blood components. Setting: A regional teach ing hospital and a district general hospital in the Oxford region of t he UK. Results: The proportion of blood components which were leucocyt e-depleted in the Oxford region of the! UK in 1996/1997 was 4.6% for r ed cells and 51.4% for platelets, and the use of leucocyte depleted pl atelet concentrates was higher than expected if the BSH guidelines wer e followed. A cost analysis suggested that there might be cast savings from the routine use of leucocyte-depleted blood for haematology and for surgical patients, although this conclusion depends on further stu dies confirming the clinical benefits of leucocyte-depleted blood comp onents for haematology and surgical patients already described in the literature. However, the cost analysis did not support the use of leuc ocyte-depleted blood for non-haematology, non-surgical patients where there is no current evidence of clinical benefit., Conclusions: The da ta presented in this study show that universal leucocyte depletion is not justified at present on the basis of clinical benefits and Cast sa vings, This conclusion could be revised if further evidence of the cli nical benefits and cost savings of leucocyte depletion of blood compon ents is provided, Indeed, in a recent development, concern about the s afety of blood transfusion in relation to new variant Creutzfeldt-Jako b disease has led to an urgent consideration of universal leucocyte de pletion of blood components in the UK.