Universal Leukoreduction Decreases the Incidence of Febrile Nonhemolytic Transfusion Reactions to Cellular Blood Components: A 5 Year Study

Abstract

Background: Febrile nonhemolytic transfusion reactions (FNHTRs) are common complications associated with allogenic transfusion and it is caused by the leucocytes and cytokines released by leucocytes during storage of blood/ blood components. These reactions are generally not life threatening, but they are expensive in their management, evaluation, and associated blood-product wastage. 1st log prestorage universal leukoreduction (ULR) i.e. removal of Buffy coat is a useful and effective procedure in developing countries to control FNHTRs significantly. Aims and Objects: To know the efficacy of pre-storage 1st log universal leuckoreduction in controlling febrile nonhemolytic transfusion reactions (FNHTRs). Place and Duration of Study: Study was carried out at Blood Bank, Department of Pathology, G. R. Medical College, Gwalior from January 2009 to December 2013 (5years). Materials and Methods: Study was divided into control group (Year: 2009) and study group (Years: 2010-13). 14,292 recipients in control group and 45,064 in study group were transfused with non-leukoreduced and prestorage 1st log leukoreduced blood/ blood components respectively. Usefulness of prestorage 1st log ULR over non-leukoreduced blood/ blood components was observed, compared and discussed. Result: In the control group 610 (4.26%) out of 14,292 (p=0.0003) and in study group 381(0.84%) out of 45,064 (p=0.0003) recipients were reported to have FNHTRs. The comparative study showed significant reduction in FNHTRs from 4.26% to 0.84% (↓ 3.42%) (p=0.000001). Conclusion: 1st log Universal Leukoreduction (ULR) is a better option over Selective Leukoreduction (SLR) to prevent FNHTRs and it also helps the transfusion services of under-resourced developing countries in many ways.