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	Leukoreduction - Wikipedia, the free encyclopedia
		Leukoreduction is the reduction of white blood cells or leukocytes from the blood or blood components being transfused to the recipient.
		Reduces risks of fever, shaking chills, immunization to white cell, platelet and perhaps red cell antigens, reduces risk of infection with cytomegalovirus.
		As of 2005, most developed nations have adopted universal leukoreduction of transfusions with the notable exception of the United States.
	en.wikipedia.org /wiki/Leukoreduction (137 words)

	Blood Safety
		He suggested that the three consensus indications for leukoreduction, namely reduced febrile transfusion reactions, reduction of alloimmunization, and reduced exposure to cell-associated pathogens, were sufficient by themselves to justify universal leukoreduction, and that the potential of universal leukoreduction to avoid unintended patient exposure to non-leukoreduced blood provided additional justification.
		Vamvakas commented that the three generally accepted indications for leukoreduction had been demonstrated in a small subset of individuals who receive transfusion, and the extrapolation of these benefits to the transfused population as a whole was without empiric support.
		He spoke in favor of universal leukoreduction on the basis of the three commonly accepted indications for this procedure, and on the basis of the currently available evidence for an immunomodulatory effect of blood transfusion.
	www.dhhs.gov /bloodsafety/summaries/sumjan01.html (2843 words)

	About Thalassemia
		A recent study of three different leukoreduction methods indicates that all are equally effective at eliminating cytomegalovirus (CMV) from blood supplies.
		Safe and effective leukoreduction is important to thalassemia patients, due to the frequency with which they are transfused.
		Leukoreduction decreases the risk not only of CMV infection but also of alloimmunization and febrile non-hemolytic transfusion reaction.
	www.cooleysanemia.org /bodies/body19.php (279 words)

	CBER - Workshop on Implementation of Universal Leukoreduction
		Whether the leukoreduction is because the filter is removing the bacteria, the filter is removing bacteria stuck to white cells or the filter are removing bacteria ingested by white cells may all be correct.
		Leukoreduction is being used increasingly to prevent transfusion reactions, alloimmunization, disease transmission, and to reduce health care complications while on transfusion.
		Leukoreduction is now mandated in at least nine countries, and a number of other countries are considering mandating it, with implementation processes that have ranged from six months to two years.
	www.fda.gov /cber/minutes/leuko121099.htm (19155 words)

	Filtering blood supply may offer some benefits
		Given the mixed evidence in favor of leukoreduction and the costs involved with adding a new procedure to blood transfusions, different countries have adopted different policies towards the practice.
		In the latest addition to the field, Dr. Paul C. Hebert and his colleagues discovered that leukoreduction may reduce the risk of death, fever and antibiotic use in people who are seriously ill, such as people in intensive care and those undergoing heart surgery.
		The agency, which recommends universal leukoreduction, collects and distributes half of the blood in the U.S. As of June 2002, 95 percent of the red blood cells distributed to hospitals by the Red Cross were leukoreduced, according to the agency.
	www.amh.org /HealthNews/reuters/NewsStory041520031.htm (856 words)

	March / April 2000 - Leukoreduction
		Leukoreduction at or near the time of collection of the unit (prestorage leukoreduction) can virtually eliminate these reactions.
		Prospective randomized studies have shown that leukoreduction of components can reduce the incidence of alloimmunization and refractoriness.(2) Based on these data leukoreduced components are now recommended for any patient requiring long term transfusion support such as patients with leukemia, lymphoma, aplastic anemia, myelodysplasia, or those undergoing stem cell transplantation.
		Clinical studies in neonates, cancer patients, stem cell transplant recipients and organ transplant recipients have shown that units rendered CMV safe by leukoreduction are equivalent to CMV seronegative units in their risk of CMV transmission (3).
	www.itxm.org /TMU2000/tmu3_4-2000.htm (1031 words)

	Blood Safety Transcripts
		Subsequent to that, in September of 1997, we discussed the effectiveness of leukoreduction for reducing the risk of blood transmission of cytomegalovirus relative to the use of cytomegalovirus antibody negative units.
		So because of the filter, the failure of preventing, completely preventing transmission both by leukoreduction and by serologic screening, the consensus conference recommended, not unanimously, that even in the face of leukoreduction, that CMV screening should be continued to be done for selected groups of patients.
		Universal leukoreduction rests on the currently unfounded premise that routine transfusion recipients are today experiencing some form of immunosuppression which would be prevented by leukoreduction.
	www.os.dhhs.gov /bloodsafety/transcripts/20010125.html (19655 words)

	ASCLS - Leukoreduced Blood Products Position Paper
		The use of a leukoreduction filter with blood products has been shown to reduce transfusion related complications in patient populations that are chronically transfused.
		The advantages of universal leukoreduction include the decrease in exposure to human leukocyte antigens and cytomeglovirus, the decrease in refractoriness to platelets and the decrease in logistic problems associated with the need to keep two blood supplies.
		Universal leukoreduction of cellular blood components be implemented as soon as feasible.
	www.ascls.org /position/leukoreduced_blood_products.asp (563 words)

	CBBS e-Network News: Universal Leukoreduction - Responses to the Opposition
		CBBS e-Network News: Universal Leukoreduction - Responses to the Opposition
		Nonetheless, there is a voluminous body of epidemiologic, animal model and randomized clinical trial data demonstrating that transfusions have profound and largely unfavorable immunologic effects on many patients, and that transfused leukocytes are responsible for some of these effects.
		In one study, mortality was reduced 60% in cardiac surgery by use of leukoreduced transfusions.
	www.cbbsweb.org /enews/ulr_pro.html (763 words)

	01-23-01 Baxter Launches New Leukoreduction Filter for Whole Blood (Site not responding. Last check: 2007-10-14)
		Leukoreduction, the removal of white blood cells, may be performed in the blood-processing center or at the transfusion recipient's bedside.
		The objective of the process is to remove white blood cells, which may trigger transfusion reactions including, fever, chills and immune reactions that limit the effectiveness of subsequent transfusions.
		Additionally, white blood cells are associated with the transmission of certain infectious diseases, such as cytomegalovirus (CMV), which may not elicit any illness in healthy individuals, but may be fatal in patients with suppressed immune systems, such as cancer patients.
	www.baxter.com /about_baxter/news_room/news_releases/2001/01-23leuko.html (445 words)

	American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont (Site not responding. Last check: 2007-10-14)
		While the FDA has not yet made leukoreduction a requirement, the American Red Cross has taken a leading role in implementing this procedure because they believe it is important.
		More than 70 percent of American Red Cross red blood cell components currently undergo prestorage leukoreduction, a filtering process that is done soon after blood is donated.
		Although it is possible to remove white blood cells as blood is being transfused, several studies have shown that prestorage leukoreduction, or leukocyte removal very soon after donation, is most effective.
	www.newenglandblood.org /leuko.htm (341 words)

	Universal Leukoreduction - College of American Pathologists (Site not responding. Last check: 2007-10-14)
		Leukoreduction is a process by which units of blood are filtered to remove white blood cells.
		Until scientific evidence clearly supports a change in policy, CAP believes that the decision to use leukoreduced products for patient care should be a medical decision and left to the medical discretion of the physician.
		If universal leukoreduction is carried out in either a local community or nationally, it should be done in a manner that does not compromise the availability of blood products in general or for special populations of patients, such as those with sickle cell disease.
	www.cap.org /apps/docs/advocacy/advocacy_issues/Issue_Leuko.html (308 words)

	American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont (Site not responding. Last check: 2007-10-14)
		Leukoreduction - or removing white blood cells from blood products, is one more step the American Red Cross is taking to make the U.S. blood supply as safe as possible.
		Most of us remember learning that there are three kinds of cells in your blood—red blood cells that carry oxygen, platelets that prompt clotting when needed, and white blood cells that fight off infections.
		Soon after this recommendation, the American Red Cross launched a leukoreduction initiative based on studies demonstrating the ability of the process to make blood transfusions safer, with a goal of leukoreducing all blood products.
	www.newenglandblood.org /safety/leuko.htm (341 words)

	Blood-filtering Program Saves Lives, Improves Health Outcomes, Ottawa Researchers Find (Site not responding. Last check: 2007-10-14)
		Although policy makers believed in the benefits of leukoreduction, its role in decreasing mortality and infection rates in surgical patients was previously unproven.
		A second study led by Dr. Dean Fergusson, a scientist with the OHRI and an epidemiologist with the University of Ottawa Centre for Transfusion Research, involved 515 premature infants weighing less than 1,250 grams (2.8 lbs) who were admitted to neonatal intensive care units (NICU) at three Canadian hospitals.
		More significantly, leukoreduction was also associated with a substantial reduction of complications of prematurity, including chronic lung injury, inflammation of the bowel, internal bleeding in the head, and retinopathy, or injury to the retinal tissue.
	www.ottawahospital.on.ca /media/news-releases/2003/04-15-03-e.asp (723 words)

	Blood Matters, Vol.2, No.1, January 2000 (Site not responding. Last check: 2007-10-14)
		Leukoreduction is not expected to prevent febrile reactions caused by the infusion of platelets that are incompatible with recipient HLA (or platelet) antibodies.
		Leukoreduction, the process of filtering residual white cells from red cell or platelet components, is associated with several well documented, some less well proven and some as yet unproven benefits that may enhance patient wellbeing (especially for regularly transfused or immunocompromised patients) and the safety of the blood supply.
		We are all aware that leukoreduction is a "good thing," because with the leukocytes we also remove the source of cytokines that cause febrile non-hemolytic transfusion reactions, HLA antigens that cause alloimmunization, intracellular virus genomes; and other mediators of transfusion-related immunomodulation.
	www.bloodlink.bc.ca /bm-jan00.htm (5663 words)

	CBER - Frequently Asked Questions on FDA's Continuing Investigation of Particulate Matter in Blood
		The FDA, CDC and state health departments are continuing to investigate the possibility of adverse reactions, but at this point we are not aware of evidence indicating an increase in adverse events due to particulate matter.
		Although leukoreduction provides known benefits to selected blood recipients and many believe that it provides additional, more general, benefits, FDA does not currently require leukoreduction of all units.
		However, because an initial enhanced visual inspection may help to identify any units with particulate matter, and because leukoreduction greatly reduces the number of units containing particulates, a second inspection after leukoreduction probably would not add significant benefit to the safety of the blood.
	www.fda.gov /cber/faq/prtbldfaq.htm (1118 words)

	Gambro BCT :: Blood Products :: Leukoreduction methods
		Leukoreduction of blood products occurs either prestorage or at the bedside of the recipient just prior to transfusion.
		With bedside leukoreduction, first whole blood is drawn.
		Gambro's prestorage leukoreduction saves key time for the blood lab through leukoreduction of blood at the same time that blood products get made.
	www.gambrobct.com /cps/rde/xchg/SID-3916ADC2-BD5C45A2/gambro-bct/hs.xsl/BloodProducts_294_ENU_HTML.htm (309 words)

	Riding up and down on the ULR seesaw - College of American Pathologists (Site not responding. Last check: 2007-10-14)
		At that time, most leukoreduction was selective—that is, physicians ordered leukoreduced blood only for patients at high risk for clinical problems that develop because of the presence of leukocytes.
		His hospital’s primary intent in converting from selective to universal leukoreduction was to decrease the incidence of febrile reactions and prevent as much as possible the occurrence of transfusion-related HLA, alloimmunization, and CMV transmission, he explains.
		He notes that leukoreduction was thought only a few decades ago to improve kidney graft survival, and the opposite turned out to be true.
	www.cap.org /apps/docs/cap_today/feature_stories/URLseesaw.html (3813 words)

	MMP May 2001 Newsletter
		While studies exist to support these benefits of leukoreduction the data is contradictory and, as yet, inconclusive.
		Problems with bedside filtration include: assuring that the appropriate filter is used for all components transfused to all patients at risk for complications of white cell transfusion, variable nursing transfusion practice affecting the efficacy of leukoreduction and rare hypotensive transfusion reactions associated with these filters.
		In the United States, the FDA has indicated that it favors a move to universal leukoreduction, but has not issued regulations mandating the change.
	www.mmphealthcare.com /newsletters/2001-05.html (546 words)

	Blood Bank Guy: Education: Transfusion Reactions (Site not responding. Last check: 2007-10-14)
		In the United States today, leukoreduction means running a blood product through a filter that is designed to remove the vast majority of the white cells in that product while retaining the vast majority of the other stuff that is in there.
		In fact, the failure of bedside or Blood Bank leukoreduction to reliably prevent FNH's in platelet transfusion was one of the observations which led those kooky researchers to discover the Platelet Mechanism for FNH's.
		Alas, more than pretransfusion leukoreduction was needed, and flying in to save the day is our next topic: Prestorage Leukoreduction.
	www.bbguy.org /education/reactions/fnhpt.shtml (313 words)

	American Red Cross Blood Services, New England Region, Maine, Massachusetts, New Hampshire, Vermont (Site not responding. Last check: 2007-10-14)
		There is an absence of anticipated regulatory action mandating leukoreduction by the Food and Drug Administration (FDA).
		Based on this recommendation, and information available at that time which supported universal leukoreduction, the Red Cross led the blood banking community in implementing leukoreduction of all blood products.
		While the FDA has expressed support for the implementation of universal leukoreduction nationwide, the agency has not provided specific guidance or regulation mandating this action.
	www.newenglandblood.org /professional/leukomod.htm (372 words)

	JAMA -- Abstract: Clinical Outcomes Following Institution of Universal Leukoreduction of Blood Transfusions for ...
		JAMA -- Abstract: Clinical Outcomes Following Institution of Universal Leukoreduction of Blood Transfusions for Premature Infants, April 16, 2003, Fergusson et al.
		period and 63/246 (25.6%) in the leukoreduction period.
		period and 44 deaths (17.8%) in the leukoreduction period.
	jama.ama-assn.org /cgi/content/abstract/289/15/1950 (467 words)

	CBBS: Whither Universal Leukoreduction? New Policy of College of American Pathologists (CAP) (Site not responding. Last check: 2007-10-14)
		AND, while you are navigating the CAP website, you might want to check the story entitled "FDA Tightens Rule, Targets Transfusion Services" which was recently published in the April 2001 issue of CAP TODAY.
		Unfortunately we cannot depend on the education of the individual physician to determine when to use Leukoreduced cells and when it is OK to just used "plain 'ol" packed cells.
		While universal leukoreduction may be overkill in some instances, it prevents the opposite problem.
	www.cbbsweb.org /enf/hotnews_ulrcap.html (560 words)

	Will we ever know if leukoreduction of red blood cells should be performed?/Saurons-nous un jour s'il faut proceder a ...
		leukoreduction was associated with lower risk of infection,
		Leukoreduction in the setting of open heart surgery: a prospective cohort-controlled study.
		Universal leukoreduction decreases the incidence of febrile nonhemolytic transfusion reactions to RBCs.
	www.cja-jca.org /cgi/content/full/51/5/407 (1910 words)

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