Universal pre-storage leukoreduction--A defensible use of hospital resources: the Yale-New Haven Hospital experience.

In conclusion, as of 2004, it appears that in the United States in some hospitals, the use of LR blood products will probably remain as SLR rather than PSULR, due primarily to economic pressures. While some blood centres are slowly converting to ULR, there remains a mix of negative and positive feelings among physicians that make adoption of a national PSULR Standard of Care difficult. What is clear is that leukoreduction filters will cost more than the 170 um screen ("clot") filter. The use of PSULR to decrease the incidence of FNHTR, to decrease the incidence of HLA alloimmunization, and its use in lieu of CMV-seronegative blood products is well supported in the medical literature. However, this issue will probably continue to be revisited and debated for some time before a national standard policy for PSULR is adopted. Finally, we believe that despite increasing economic pressures and worsening budgetary constraints, the decision to adopt PSULR should rest primarily on medical reasons: as a means of improving patient care. In the view of the authors, pre-storage universal leukoreduction qualifies as a significant and medically justifiable improvement in the care of all hospital patients.