Lane T A
University of California-San Diego School of Medicine, La Jolla 92093-0612.
Arch Pathol Lab Med. 1994 Apr;118(4):392-404.
Cellular blood components contain passenger donor leukocytes. Transfusion of passenger leukocytes may be associated with alloimmunization to leukocyte antigens, febrile transfusion reactions, refractoriness to platelet transfusion, severe pulmonary dysfunction, graft-vs-host disease, the transmission of infectious diseases, and immune modulation. Advanced leukocyte-reduction filters enable the removal of up to 99.9% of leukocytes from cellular blood components. Clinical trials suggest that the use of leukocyte-reduction filters may prevent or diminish the probability of febrile transfusion reactions, alloimmunization, and cytomegalovirus infection, but controversy exists regarding the effectiveness of leukocyte reduction in preventing immune modulation. There is no evidence that available techniques will prevent graft-vs-host disease. Cost-benefit analyses support the use of leukocyte-reduction filters for well-defined indications. Standards for leukocyte reduction of red blood cells have been defined, but issues regarding the quality control of leukocyte-reduced blood components require additional study.
血液中的细胞成分含有供体过客白细胞。输注过客白细胞可能与白细胞抗原的同种免疫、发热性输血反应、血小板输注无效、严重肺功能障碍、移植物抗宿主病、传染病传播以及免疫调节有关。先进的白细胞滤除器能够从血液细胞成分中去除高达99.9%的白细胞。临床试验表明，使用白细胞滤除器可能预防或降低发热性输血反应、同种免疫和巨细胞病毒感染的可能性，但关于白细胞滤除在预防免疫调节方面的有效性仍存在争议。没有证据表明现有技术能预防移植物抗宿主病。成本效益分析支持在明确的适应症中使用白细胞滤除器。已经定义了红细胞白细胞滤除的标准，但关于白细胞滤除血液成分质量控制的问题还需要进一步研究。
