Reduction of febrile but not allergic reactions to RBCs and platelets after conversion to universal prestorage leukoreduction
Reduction of febrile but not allergic reactions to RBCs and platelets after conversion to universal prestorage leukoreduction
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DOI：
10.1046/j.0041-1132.2004.00608.x
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发表时间：
2004-01-01
期刊：
影响因子：
2.9
通讯作者：
Snyder, EL
中科院分区：
文献类型：
--
作者：
Paglino, JC;Pomper, GJ;Snyder, EL
背景：1995 年 1 月至 1998 年 11 月期间，在耶鲁纽黑文医院，25% 的输注红细胞通过预储存或床边白细胞去除过滤器进行处理，这些过滤器根据每位患者进行选择（选择性白细胞去除 [SLR]）。 1995 年 1 月至 1999 年 7 月期间，30% 的浓缩血小板 (PC) 通过床边白细胞减少过滤器输注。为了减少发热性非溶血性输血反应 (FNHTR)，1998 年 11 月至 1999 年 12 月期间对红细胞的 SLR 改为通用储存前白细胞减少术 (UPL)，1999 年 7 月至 2000 年 1 月期间对随机供体 PC 进行了改变。对 1995 年 1 月至 2002 年 12 月报告的 FNHTR 和过敏性输血反应 (ATR) 进行了审查。设计和方法：为了进行回顾性观察分析，血库数据包括从 1995 年到 2002 年 12 月输注的 RBC 和 PC 数量、白细胞减少产品百分比以及 FNHTR 和 ATR 率。将该时间段分为三个阶段（SLR、过渡和 UPL）后，使用比值比 (OR) 和 Student t 检验对这些数据进行评估。 结果：对 1995 年 1 月至 2002 年 12 月期间输注的 145,369 个红细胞和 137,982 个 PC（29,487 个 PC 池）进行了评估。对于 RBC，相对 FNHTR 率下降了 47.1%，从 0.34% (SLR) 降至 0.18% (UPL) (p < 0.0001)。 SLR 和 UPL 组的红细胞 ATR 率均为 0.09%（p > 0.05，NS）。对于 PC，FNHTR 相对率下降了 93.1%，从 SLR 的 2.18% 降至 UPL 的 0.15% (p < 0.0001)。 ATR 的发生率分别为 0.49% (SLR) 和 0.35% (UPL)（p > 0.05，NS）。 结论：引入 100% UPL 后，红细胞和 PC 的输血后 FNHTR 频率显着降低，但 ATR 没有显着降低。这些数据支持这样的假设：与选择性白细胞减少术相比，红细胞和 PC 的 UPL 实践降低了 FNHTR 的频率，从而改善了患者护理。
BACKGROUND: Between January 1995 and November 1998, at Yale-New Haven Hospital, 25 percent of RBCs transfused were processed through prestorage or bedside leukoreduction filters, chosen on a per patient basis (selective leukoreduction [SLR]). Between January 1995 and July 1999, 30 percent of platelet concentrates (PCs) were infused through bedside leukoreduction filters. In an attempt to decrease febrile nonhemolytic transfusion reactions (FNHTR), a change was made from SLR to universal prestorage leukoreduction (UPL) for RBCs between November 1998 and December 1999 and for random donor PCs between July 1999 and January 2000. FNHTR and allergic transfusion reactions (ATR) reported from January 1995 through December 2002 were reviewed.STUDY DESIGN AND METHODS: For retrospective observational analysis, blood bank data were available on the number of RBCs and PCs transfused, percent products leukoreduced, and rate of FNHTR and ATR from 1995 through December 2002. After dividing this time period into three phases (SLR, transition, and UPL), these data were evaluated using odds ratio (ORs) and Student's t tests.RESULTS: A total of 145,369 RBCs and 137,982 PCs (29,487 PC pools) transfused between January 1995 and December 2002 were evaluated. For RBCs, the relative FNHTR rate decreased 47.1 percent, from 0.34 percent (SLR) to 0.18 percent (UPL) (p < 0.0001). ATR rates for RBCs showed 0.09 percent for both SLR and UPL groups (p > 0.05, NS). For PCs, the FNHTR relative rate decreased 93.1 percent, from 2.18 percent for SLR to 0.15 percent for UPL (p < 0.0001). Rates for ATR were 0.49 percent (SLR) and 0.35 percent (UPL) (p > 0.05, NS).CONCLUSIONS: A significant decrease in the frequency of posttransfusion FNHTR, but not ATR, for RBCs and PCs followed introduction of 100-percent UPL. The data support the hypothesis that the practice of UPL of RBCs and PCs decreases the frequency of FNHTR and thus improves patient care over the practice of selective leukoreduction.