[白细胞去除对浓缩红细胞输血反应的影响]

[The effect of leukocyte-reduction on the transfusion reactions to red blood cells concentrates].

作者信息

Mukagatare I, Monfort M, de Marchin J, Gerard C

机构信息

Service d'immunohématologie, banque de sang, CHU Sart-Tilman, université de Liège, avenue de l'Hôpital, Liège, Belgique.

出版信息

Transfus Clin Biol. 2010 Feb;17(1):14-9. doi: 10.1016/j.tracli.2009.12.001. Epub 2010 Jan 27.

Abstract

SUBJECT

In order to assess the impact of leukocyte reduction, all transfusion reactions reported at Liege Teaching Hospital's Blood Bank 2 years before and after the implementation of universal leukocyte reduction of red blood cells concentrates which started-up on 1 January 2005 were evaluated.

STUDY DESIGN AND METHODS

A retrospective analysis of transfusion reactions from 1 January 2003 to 31st December 2006 was undertaken. Data were collected from computerized reports, which were entered as soon as a transfusion reaction was reported. Symptoms were classified in different reaction's categories. Blood cultures, antibody screening and direct antiglobulin test were performed. Differences between the two time periods, before (2003-2004) and after (2005-2006) universal leukoreduction were determined by the Chi-square test and significance was defined as a p value less than 0.05.

RESULTS

During period before the implementation of systematic leukoreduction, 68.7% of red blood cells transfused were leukoreduced. A total of 365 transfusion reactions in 91,996 red blood cells units transfused (0.4%) were reported, of which 266 were classified as febrile non-hemolytic transfusion reactions (72.9%), followed by allergic reactions (7.1%) and miscellaneous reactions (3.8%). When comparing the two-time periods, the rate of all transfusion reactions in general significantly decreased from 0.49 to 0.31% (p<0.001). Therefore, universal leukocyte reduction significantly reduced the rates of febrile non-hemolytic transfusion reactions (0.35% versus 0.24%; p=0.002) and allergic reactions (0.05% versus 0.01%; p<0.001).

CONCLUSION

Universal leukocyte reduction significantly reduced the rate of transfusion reactions.

摘要

主题

为评估白细胞去除的影响,对列日教学医院血库在2005年1月1日开始实施红细胞浓缩物普遍白细胞去除前后两年报告的所有输血反应进行了评估。

研究设计与方法

对2003年1月1日至2006年12月31日的输血反应进行回顾性分析。数据从计算机化报告中收集,输血反应报告后立即录入。症状被分类到不同的反应类别中。进行了血培养、抗体筛查和直接抗球蛋白试验。通过卡方检验确定普遍白细胞去除前(2003 - 2004年)和后(2005 - 2006年)这两个时间段之间的差异,显著性定义为p值小于0.05。

结果

在系统白细胞去除实施前的时期,68.7%的输注红细胞进行了白细胞去除。在输注的91,996个红细胞单位中,共报告了365例输血反应(0.4%),其中266例被分类为发热性非溶血性输血反应(72.9%),其次是过敏反应(7.1%)和其他反应(3.8%)。比较这两个时间段时,总体所有输血反应的发生率从0.49%显著降至0.31%(p<0.001)。因此,普遍白细胞去除显著降低了发热性非溶血性输血反应的发生率(0.35%对0.24%;p = 0.002)和过敏反应的发生率(0.05%对0.01%;p<0.001)。

结论

普遍白细胞去除显著降低了输血反应的发生率。

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