What is your procedure for whether to give platelet filters to patients who receive leuko-reduced pheresis platelets? Our policy is to give platelet filters for all platelet transfusions, but a recent new hire said that the facilty at which they use to work did not give platelet filters to patients who received leuko-reduced pheresis transfusions. Any opinions would be appreciated.

Thanks,

Doug

I would always give platelets through a filter, even if they have gone through LR.

The problem is that, not each and every platelet unit is quality tested for LR, only a proportion (at least, in the UK) and, therefore, if the LR filter had failed, you wouldn't know it, so belt and braces seems far safer (if a little more expensive - less expensive than litigation though!).

In the US, when leukoreduced Apheresis platelets are collected, leukoreduction does not occur by filtration -- rather, by the process of collection. The instruments are designed to detect instances that might cause WBC contamination of a leukoreduced product and alert the operator. I don't know what technology your supplying Blood Center uses Doug, but we use the Trimas at our facility. We test 36 random products per month for QC (we will be increasing that to 60 once we implement changes to be in-line with the 2007 Guidance Document) and 100% of the products that are flagged by the instrument. The rate of high WBCs in the randomly selected products is about once per year, which means that only about 0.2% of the products that we label as leukocyte reduced are not. Again, you can talk to your blood center to verify that the data applies to them as well. If that is the case, then giving the platelets through a leukoreduction filter is probably not necessary, and a standard infusion set would be appropriate.

Since all our products are leukoreduced at the blood center, it's been a very long time since I've use and leukoreduction filters, but I seem to remember the product insert of the last filter we used stating the filter was not for use with leukoreduced products. Have you checked the product insert?

PamD,

Thanks for the response and yes I checked the package insert and it doesn't state anything about not giving filters with leuko-reduced products. I geuss I should have made my initial post a little clearer. The filters (PALL PXL8) also remove microaggregates and C3a so I was wondering more about these factors then the actual leuko-reduction of the filter. Does a pheresis unit need these removed? I guess that is a better way to put my question. I think that due to a possible microaggregate or a C3a situation that it is stilll best to give a platelet filter. Also after asking around, I found out that some of the regular tubing used by the units at some facilities have these type filters built in. Does anyone know anything about this?

Thanks,

Doug

Thanks,

Please see my response to PamD if you could provide any further assistance.