The case for universal leukoreduction of blood transfusions

Leukoreduction is the process by which most donor leukocytes are removed from blood components either at the time of blood product manufacture or prior to transfusion. It has been shown to reduce the incidence of febrile nonhemolytic transfusion reactions, transfusion transmitted CMV infections, HLA alloimmunization and platelet refractoriness. Despite the reported benefits of leukoreduction, the FDA has not taken action to implement universal leukoreduction. In this review, we discuss the evidence from observational, retrospective and randomized controlled trials for and against leukoreduction. We advocate for the adoption of universal leukoreduction, which would improve patient outcomes and pay for itself.