van Aken W G, Brand A, van der Poel C L
Sanquin/Centraal Laboratorium van de Bloedtransfusiedienst, Amsterdam.
Ned Tijdschr Geneeskd. 2000 May 27;144(22):1033-6.
The presence of leukocytes in blood products has no beneficial effect on the recipient, except in special situations such as for patients being prepared to receive an organ transplantation. On the other hand the leukocytes have a number of untoward side effects such as HLA immunisation, non haemolytic febrile transfusion reactions, virus transmission and postoperative infections. In response to a request of the Minister of Health, Welfare and Sports, the Health Council of the Netherlands prepared a recommendation on the need of routine leukodepletion by filtration of blood. Although the introduction of leukodepletion of blood products is favoured, it is emphasized that only data from selected patient groups are available while the costs of leukodepletion are considerable. Therefore, an evaluation of the benefits and cost effectiveness of blood filtration is recommended. It is argued that leukodepletion, already introduced in a number of countries, is now considered to be 'state of the art'. Furthermore product liability, public opinion about blood safety and the precaution duty of manufacturers should be taken into account.
血液制品中白细胞的存在对受血者没有益处,除非在特殊情况下,如准备接受器官移植的患者。另一方面,白细胞有许多不良副作用,如HLA免疫、非溶血性发热输血反应、病毒传播和术后感染。应卫生、福利和体育部部长的要求,荷兰卫生委员会就通过血液过滤进行常规白细胞去除的必要性编写了一份建议。尽管倾向于采用血液制品白细胞去除法,但强调目前仅有部分特定患者群体的数据可用,且白细胞去除的成本相当高。因此,建议对血液过滤的益处和成本效益进行评估。有人认为,一些国家已经采用的白细胞去除法现在被视为“先进技术”。此外,还应考虑产品责任、公众对血液安全的看法以及制造商的预防义务。