Universal leucocyte reduction of blood components: a need for evidence-based decision making

By the time this chapter is published, the majority of western based transfusion services will probably have mandated universal leucocyte reduction (ULR) as a requirement for blood components. This measure, which has entered the transfusion environment over the past three years, has divided the blood banking community like few other issues over its history. To those who, like the author, have been aware of the possible benefits of leucocyte reduction for many years, the rush towards the universal implementation of a very expensive measure has resulted in a sense of bemusement rather than otherwise. This chapter does not seek to replicate the many excellent reviews outlining the pros and cons of this issue. Rather, active consideration of evidence-based leucocyte reduction is proposed against a background of the possibilities imposed by the logistics and constraints which current transfusion medicine experiences.