The Status of Use of Leukoreduced Blood Products in Korean Hospitals

BACKGROUND: Leukoreduced blood components are recommended for prevention of non-hemolytic febrile transfusion reactions, HLA alloimmunization, platelet transfusion refractoriness, and transfusion-transmissible diseases. In addition, prestorage leukoreduction may be advantageous to poststorage leukoreduction. The authors investigated the current status of usage of leukoreduced blood components in Korea. METHODS: We surveyed 2,373 medical facilities, where blood components were supplied from Korean Red Cross blood centers and/or Hanmaeum blood center during one year period between January and December 2009. The survey was conducted about the current situation of usage of leukoreduction by web-based program (http://bms.cdc.go.kr), and 743 facilities answered and were analyzed. RESULTS: The leukoreduced RBC components comprised 10.3% (prestorage leukoreduction, 91,066 units, 5.7%; poststorage leukoreduction 73,192 units, 4.6%) of the total 1,593,098 units of RBC components used in 743 medical facilities. The leukoreduced platelet concentrates comprised 33.1% (458,552 units) of the total 1,386,184 units of platelet concentrates used in 397 medical facilities. If 1 single donor platelet is counted as 6 platelet concentrates, 48.9% of the total platelet components used were leukoreduced. CONCLUSIONS: The proportion of leukoreduced blood components to the total blood components used in Korea was much lower than that in Unites States of America, especially lower in the use of prestorage leukoreduction of RBC components. Further studies are required for cost-effectiveness and demand-supply amounts of leukoreduced blood components, and appropriate prestorage leukoreduction has to be performed in Korea based on these studies.

Prestorage leukoreduced RBCs: Evaluation for two different quadruple collection bags with an inline RBC filter / 대한수혈학회지

BACKGROUND: The Korean Red Cross(KRC) are considering the introduction of prestorage leukoreduced RBCs, as it is thought one of best way to prevent WBC-associated adverse transfusion reactions. We evaluated two different quadruple top-and-bottom collection bags, specially designed for this purpose by two manufacturers(Boin Medica Co.,Ltd and Green Cross Medical Corporation, Korea), consisted of a CPD bag, a SAG-M bag and an inline RBC filter, either RCM1 (Pall Medical, U.S.A.) or BioR 01 1N (Fresenius Hemocare, Germany) each. METHODS: Fifty one bags from Boin and sixty bags from Green Cross and consequent blood components were studied in twice over a period of two years. As an inline filter, Boin used RCM1 and Green Cross used RCM1(1st) and BioR 01 1N(2nd). They were divided into group A(filtration performed after processing of RBCs) and B(filtration performed after storage of overnight at 4 degrees C). WBC-reduced RBCs were tested for pH, plasma K+, plasma Hb and blood culture every 7 days to investigate storage time-dependent changes up to 42 days. RESULTS: The results of pH, plasma K+ and plasma Hb from CPD added whole blood, RBCs, SAG-M added RBCs and WBC-reduced RBCs did not show significant differences. We observed both of adding SAG-M solution and filtration procedure did not effect on the prestorage leukoreduced RBCs. WBCs were removed effectively by prestorage filtration. But in the case of failed units, the design or method to integrate an RBC filter may be a cause for the failure. CONCLUSION: We concluded that two different quadruple collection bags with integral RCM1 filter from Boin(2nd) and Green Cross(1st) are useful for production of prestorage leukoreduced RBCs.

The effect of leukoreduction on the IL-2 and IL-8 leveIs in blood storage / 中国免疫学杂志

Investigate the effect of prestorage white cell filtration on the cytokines content in blood. Methods: Ten units of whole blood was divided into two parts just after blood collection:one was used as control, the other was filtrated by leukoreduction filters. All units were stored at 4℃ for 6 weeks. Immediately after filtration and every week subsequently, samples for analses of IL-2, IL-8 were obtained. Results:The amounts of IL-2 and IL-8 increased during the storage period. In filtered units, the amounts of IL-8 did not increase during the study period, IL-2 still increased but was still lower than that of unfiltered units at the end of storage. Conclusion: Many cytokines, such as IL-2 and IL-8, were generated and accumulated in blood during blood storage. Leukocyte filtration may prevent this effect to some extend. Prestorage filtration may decrease FNHTRs by preventing the accumulation of cytokines in blood.