The preparation of red cells depleted of leukocytes. Review and evaluation.

The most commonly used methods for depleting red cells of leukocytes are the inverted spin procedure, which results in excessive red cell loss and poor leukocyte depletion, and washing, which is expensive and yields a product with a 24-hour shelf life. Clinical data now available suggest that nonhemolytic febrile transfusion reactions can be prevented in most clinical situations by microaggregate filtration of red cells during transfusion using the spin-cool-filter procedure with a screen filter. This procedure holds advantages for leukocyte removal, red cell recovery, cost, normal shelf-life, and simplicity over other washing and buffy coat removal procedures currently used. For highly alloimmunized patients requiring virtually total leukocyte removal and where alloimmunization is to be avoided at any cost, adhesion filtration or freezing and deglycerolization should be used.