Universal leucocyte depletion has been implemented in the UK and several ot
her European countries as a precautionary measure against the potential ris
k of transmission of variant Creutzfeldt-Jakob disease by blood transfusion
. Leucocyte depletion had previously only been recommended for a relatively
small proportion of transfusion recipients based on clinical and experimen
tal evidence showing clinical benefit. However there is now increasing evid
ence to support its value in preventing transfusion transmission of infecti
ous agents and in reducing some of the adverse immunomodulatory effects of
allogeneic transfusion. The financial costs of providing universal leucocyt
e depletion are substantial, but, if it transpires that leucocyte depletion
has a beneficial effect in reducing, for example, postoperative infection
rates, then the health economic gains in this patient group alone may large
ly or wholly offset these financial costs. The experience in the UK and oth
er European countries in terms of these collateral clinical benefits will h
elp other countries, where the risk of variant Creutzfeldt-Jakob disease ma
y not be so great, to decide whether to similarly adopt universal leucocyte
depletion. (C) 2000 Harcourt Publishers Ltd.