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Transfusion expert urges wider use of filtered blood

Filtering white cells from donor blood before a transfusion is much safer for patients and long overdue as a national standard for all surgical procedures, according to University of Rochester researchers who present their analysis in the April journal, Transfusion.

The practice of removing the white cells from blood is called leukoreduction. But despite the recommendations of two national advisory committees in 10 years that voted in favor of all patients in the United States receiving leukoreduced blood, ("universal leukoreduction"), the practice is still not wholly supported in the medical community, nor recommended by the Food and Drug Administration. Part of the reason is fear of increased cost.

However, Neil Blumberg, M.D., lead author of the study and a proponent of leukoreduction, argues that several cost-benefit analyses show that an upfront increase of $25 to $35 for each unit of filtered blood is offset by savings from less use of antibiotics, reduced patient time in the ICU, and shorter lengths of hospital stays overall. One study, in fact, estimated that the savings in treating heart surgery complications alone could total $1 billion a year, nationwide.

"Rarely do we come up with a medical advance that saves money and is better for patients at the same time. This is as basic as washing your hands before conducting a physical examination of a patient," Blumberg said. "But despite much scientific evidence that supports this notion, millions of people today are still receiving transfusions that might needlessly be harmful to them. The single most effective and overdue safety measure the FDA could take at this time is to mandate leukoreduction of all transfusions through its regulatory power."

Blumberg's group reviewed approximately 520 abstracts and nine published randomized clinical trials, on the risks and benefits of using leukoreduced blood. They assessed the statistical methods that were used in each study, and fo
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Source:University of Rochester Medical Center


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