During allogeneic blood transfusion a person receives large number of allogeneic donor leukocytes and these are recognized as foreign cells by the recipient immune system which leads to several adverse reactions. To avoid such leukocyte-mediated adverse reactions leukodepleted blood transfusion is preferred. The aim of this study is to compare the feasibility and efficacy of Pall Purecell (RC2DAVE) High efficiency leukocyte reduction filter versus standard Pall (SQ40SKLE) blood transfusion set which filters microaggregates of leukocytes, platelets and blood clots and comparing both against a control blood transfusion set (Romsons Juniors India Unit II).
In this study thirty (30) adult patients undergoing CPB for Coronary Artery Bypass Grafting (CABG), were allocated randomly to a leukocyte depleting filter group B (n=10), Pall set group A (n=10), and a control group C (n=10). In the leuko-depletion group B the leukocyte filtration was achieved with Pall PURECELL high efficiency leuko-reduction filter, In pall set group B Pall filter (SQ40SKLE) and in the control group C (Romsons Juniors India Unit II blood administration set). Peri-operative leuko-filtration was commenced after going on CPB for blood transfusion to increase the hematocrit of the patient's blood.
The mean leukocyte removal calculated from the difference in pre-filtered blood sample Total Leukocyte Count (TLC) and post-filtered blood sample TLC was around 74% in the leuko-depletion group B. Circulating leukocytes in circuit were reduced by 83% of total leukocytes in depletion group B and by 43% in group A compared with group C. In leukodepleted group the postoperative inflammatory responses in the form of febrile reaction, ICU stay and serum creatinine level were reduced. Infection rate compared with control group C and Pall set group B fell from 20% to 0% in leukodepleted group.
During this study the high efficiency leukocyte reducing filter used in group B was found to be beneficial to deplete 83% of leukocyte from the circulating blood in the circuit during CPB compared with a standard 40μ rated blood transfusion set in group A and the control group C. A High efficiency leukocyte reducing filter provides better clinical outcomes with no mortality against control, comparatively short duration of ICU stay and no infection rate than with (10%) in group A and (20%) in control group C.
