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Transfusion expert urges wider use of filtered blood

und what they believed to be flawed data in some cases. The chief problem, Blumberg's group discovered, was that some studies included hundreds of patients who never received blood transfusions. These patients would have been irrelevant to a study assessing the risks and/or benefits of certain types of transfusions, because they couldn't have benefited nor could they have been harmed by a transfusion. Furthermore, some studies used data that did not reflect actual investigative results, Blumberg said.

When the data was restricted to patients receiving transfusions, researchers found that post-surgical infection rates dropped from 33 percent to 23 percent. In other words, the relative risk of infection dropped by about 30 percent for the patients with leukoreduced blood.

"Our data would suggest that when you combine all of the safety measures that have been made to the blood supply since the AIDS epidemic, all of those safety adjustments combined are is still less beneficial to patients than the benefits of leukocyte reduction," Blumberg said.

Transfusions are done routinely, and some practitioners are not convinced they hold many risks. But doctors at the University of Rochester, leaders for two decades in the study of "transfusion immunomodulation," believe otherwise. Giving donor blood to someone, Blumberg said, is akin to a temporary organ transplant. In many cases the transfused blood modifies a person's immune system ?either in a favorable or unfavorable way ?by interacting with the patient's own white cells.

Removing the foreign white cells from transfused blood reduces the chances of a negative reaction by the host immune system. In 1998 the University's Strong Memorial Hospital was among the first hospitals in the country to begin using leukoreduced blood for all cardiac surgery cases. Since then, the hospital has extended its leukoreduction practice to all patients, beginning in 2000.


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Source:University of Rochester Medical Center


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