Leukocyte reduction of blood components significantly improves the quality of labile blood products by avoiding or reducing the transfusion-associated side effects of leukocytes such as febrile non-hemolytic transfusion reactions, transmission of leukotropic viruses (CMV, HTLV I/II) and the release of cytokines during storage. However, leukocyte reduction by filtration results in a loss of cells and may have an impact on red blood cell (RBC) storage.

In the present study, the effect of leukocyte filtration on the RBC storage lesion was investigated with respect to hemolysis, irreversible echinocytosis, microvesiculation, removal signaling, band 3-related senescence modifications, and membrane stress biomarkers. Compared to non-leukoreduced RBCs, the currently reported molecular and cellular data provide a mechanistic basis for the improved quality and post-transfusion recovery of prestorage leukocyte reduced RBCs.

Despite the impressive number of tests performed to show the influence of pre-storage leukocyte reduction on the RBC storage lesion, unfortunately the number of units studied was small (n = 4), resulting in poor statistical power.

– Rainer Moog