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Washing red cells after leucodepletion does not decrease human leukocyte antigen sensitization risk in patients with

Antony Aston¹, Rebecca Cardigan, Saber Bashir

¹Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.

Pediatric Nephrology (Berlin, Germany)

|April 30, 2014

Summary

Washing leucodepleted red cells does not reduce human leukocyte antigen (HLA) sensitization rates in children with chronic kidney disease. This method has a limited effect on residual leukocytes, making it unlikely to decrease HLA sensitization risk.

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Area of Science:

Nephrology
Immunology
Transfusion Medicine

Background:

Standard leucodepleted blood transfusions can lead to human leukocyte antigen (HLA)-specific antibodies.
These antibodies are linked to increased transplant waiting times and reduced graft survival.
Additional washing of leucodepleted red cells was investigated to reduce antigenic stimulus.

Purpose of the Study:

To evaluate if washing leucodepleted red cells reduces HLA sensitization rates in children with chronic kidney disease (CKD).
To assess the efficacy of manual and automated washing methods in reducing residual leukocytes.

Main Methods:

Retrospective review of 106 children with CKD stage 4-5 who underwent HLA antibody screening.
Patients were categorized based on receiving standard leucodepleted blood or washed cells.
Leukocyte counts were measured before and after washing standard leucodepleted red cells.

Main Results:

No significant difference in HLA sensitization rates was observed between standard and washed red cells.
Both manual and automated washing methods showed limited effectiveness in reducing residual leukocytes.
Automated washing achieved a 33% reduction but left a majority of leukocytes.

Conclusions:

Washing leucodepleted red cells did not demonstrate a reduction in patient HLA sensitization rates.
The limited impact on residual leukocyte reduction suggests washing is unlikely to decrease HLA sensitization risk.