The study is very important with regard to the question of whether plasma-poor RBCs cause less immunosuppression than RBC units containing more or less plasma (e.g., whole blood). It can be concluded that plasma does not create any additional immuno-suppressive risk. This is important since leukodepleted whole blood may become a valuable blood product for perioperative and posttraumatic bleeding anemia in the future. The study cannot answer the question of whether plasma itself has any immunosuppressive effect since all patients receiving plasma also received RBCs containing buffy coat which certainly, if at all, are covering up the effect of plasma.

– V. Kretschmer.