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The influence of leukoreduction on the acute transfusion-related complication rate in 455 dogs receiving 730 packed
Elizabeth B Davidow1, Heather Montgomery1, Michelle Mensing1
1ACCES Blood Bank, BluePearl Veterinary Partners, Seattle, Washington, USA.
Objective:
To investigate the influence of prestorage leukoreduction of packed RBCs (pRBCs) on acute transfusion-related complication rate in dogs.
Setting:
Two private referral hospitals.
Design:
Retrospective case study.
Animals:
Four hundred and fifty-five dogs receiving nonleukoreduced (nLR) or leukoreduced (LR) pRBC between January 1, 2014 and July 31, 2017.
Measurements And Main Results:
Transfusions were retrospectively reviewed to record data about the patient, donor, unit, transfusion event, acute complications, hospital discharge, and cause of death. Of 730 transfusion events in 455 dogs, 288 used LR pRBC and 442 used nLR pRBC. There was a 18.9% (138/730) overall complication rate. Seven (0.96%) complications were life-threatening. The most common complications were pyrexia (5.6%), gastrointestinal signs (4.9%), and hemolysis with no other signs (4.1%). Pyrexia with no other clinical signs, consistent with a febrile nonhemolytic transfusion reaction (FNHTR), occurred in 3.2% of transfusion events. There was a significant (P = 0.03) decrease in the rate of FNHTR with LR pRBC (1%) versus nLR pRBC (4.5%). Use of LR pRBC did not decrease in-hospital mortality. The odds of any complication, hemolysis only, FNHTR, and more severe complications increased with pRBC age. Leukoreduction did not decrease the impact of pRBC age on these complications. Use of older pRBC did not increase the incidence of life-threatening complications or mortality. Dogs receiving pRBC for blood loss were more likely to have gastrointestinal and more severe complications than those dogs that had hemolysis. The effect of pRBC unit age on complications was not influenced by the underlying reason for transfusion. Dogs that received a previous transfusion were more likely to have respiratory complications.
Conclusion:
In this study, the use of LR pRBC was associated with a decreased rate of FNHTR but no other complications. Unit age was associated with the incidence of hemolysis, FNHTR, and complication severity but not the rate of life-threatening complications or mortality.
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