Sharma R R, Marwaha Neelam
Department of Transfusion Medicine, PGIMER, Chandigarh, India.
Asian J Transfus Sci. 2010 Jan;4(1):3-8. doi: 10.4103/0973-6247.59384.
Removal of leucocytes from various blood products has been shown to minimize Febrile nonhemolytic transfusion reactions, HLA alloimmunization, platelet refractoriness in multitransfused patients and prevention of transmission of leukotropic viruses such as EBV and CMV. Rapidly growing size of hemato-oncological patients in our country requiring multiple transfusion of blood and components during the course of their management pose a great challenge to transfusion services to provide them red cell and platelet antigen matched products in alloimmunized subjects. Thus removal of leucocytes below a certain threshold, </= 5 x 10(6) in a blood component certainly helps in prevention of alloimmunization and associated risks in these patients. Currently the best Leucoreduction can be achieved with the help of 3rd and 4th generation leukofilters, both in laboratory and patient bed side, and state of the art apheresis devices. The present article briefly reviews the current literature for pros and cons of leucofilteration and its scope of implementation in the cost constrained settings.
已证明从各种血液制品中去除白细胞可最大程度减少发热性非溶血性输血反应、HLA同种免疫、多次输血患者的血小板不应答以及预防嗜白细胞病毒(如EBV和CMV)的传播。在我国,血液肿瘤患者数量迅速增加,他们在治疗过程中需要多次输血和血液成分,这给输血服务带来了巨大挑战,即在同种免疫个体中为他们提供红细胞和血小板抗原匹配的产品。因此,将血液成分中的白细胞去除至低于某个阈值(≤5×10⁶)肯定有助于预防这些患者的同种免疫及相关风险。目前,借助第三代和第四代白细胞滤器,无论是在实验室还是患者床边,以及最先进的单采设备,都能实现最佳的白细胞去除效果。本文简要回顾了当前关于白细胞过滤利弊的文献及其在成本受限环境中的实施范围。