PMID- 24777534
OWN - NLM
STAT- MEDLINE
DCOM- 20150602
LR  - 20211021
IS  - 1432-198X (Electronic)
IS  - 0931-041X (Linking)
VI  - 29
IP  - 10
DP  - 2014 Oct
TI  - Washing red cells after leucodepletion does not decrease human leukocyte antigen 
      sensitization risk in patients with chronic kidney disease.
PG  - 2005-11
LID - 10.1007/s00467-014-2823-6 [doi]
AB  - BACKGROUND: Standard leucodepleted blood transfusions can induce the production 
      of human leukocyte antigen (HLA)-specific antibodies, which are associated with 
      longer transplant waiting times and poorer graft outcomes. We hypothesized that 
      additional washing of leucodepleted red cells might reduce antigenic stimulus by 
      removal of residual leukocytes and soluble HLA. METHODS: A retrospective review 
      of HLA antibodies in children with chronic kidney disease stage 4-5 who had >/= two 
      HLA antibody screens between 2000 and 2009, pre- and post-transfusion, and were 
      HLA antibody-negative at first testing. Patients were divided according to 
      whether they received standard leucodepleted blood or "washed cells". To assess 
      the efficacy of washing methods, total leukocytes were enumerated pre- and post- 
      manual and automated washing of standard leucodepleted red cells that had been 
      supplemented with whole blood to achieve measurable leukocyte levels pre-washing. 
      RESULTS: A total of 106 children were included: 23 received no blood transfusions 
      (group 1), six had washed cells only (group 2), 59 had standard transfusions only 
      (group 3), and 18 had both standard and washed cells (group 4). Sensitization 
      rates were 26, 17, 44, and 44 % in groups 1-4 (p = 0.32). Patients in groups 3 
      and 4 had more transfusions with red cells, platelets, and plasma products. There 
      was no difference in HLA sensitization risk with washed or standard red cells on 
      analysis of co-variance controlling for platelets and plasma transfusions. The 
      red cell washing study showed no significant reduction in leukocytes using manual 
      methods. Although there was a statistically significant reduction (33 %) from 
      baseline pre-washing using the automated method, from 6.54 +/- 0.84 x 10(6) to 
      4.36 +/- 0.67 x 10(6) leukocytes per unit, the majority of leukocytes still 
      remained. CONCLUSIONS: There was no evidence that using washed leucodepleted red 
      cells reduced patient HLA sensitization rates. Washing leucodepleted red cells is 
      unlikely to reduce the risk of HLA sensitization due to the limited effect on 
      residual leukocytes.
FAU - Aston, Antony
AU  - Aston A
AD  - Paediatric Nephrology, Great Ormond Street Hospital for Children, London, UK.
FAU - Cardigan, Rebecca
AU  - Cardigan R
FAU - Bashir, Saber
AU  - Bashir S
FAU - Proffitt, Susan
AU  - Proffitt S
FAU - New, Helen
AU  - New H
FAU - Brown, Colin
AU  - Brown C
FAU - Liesner, Ri
AU  - Liesner R
FAU - Hennem, Sylvia
AU  - Hennem S
FAU - Nulty, Helen
AU  - Nulty H
FAU - Shaw, Olivia
AU  - Shaw O
FAU - Vaughan, Robert
AU  - Vaughan R
FAU - Kim, Jon Jin
AU  - Kim JJ
FAU - Rees, Lesley
AU  - Rees L
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140429
PL  - Germany
TA  - Pediatr Nephrol
JT  - Pediatric nephrology (Berlin, Germany)
JID - 8708728
RN  - 0 (HLA Antigens)
RN  - 0 (Isoantibodies)
SB  - IM
MH  - Child
MH  - Erythrocyte Transfusion/*adverse effects/*methods
MH  - Female
MH  - HLA Antigens/*immunology
MH  - Humans
MH  - Isoantibodies/*blood
MH  - Leukapheresis/*methods
MH  - Male
MH  - Renal Insufficiency, Chronic/*therapy
EDAT- 2014/04/30 06:00
MHDA- 2015/06/03 06:00
CRDT- 2014/04/30 06:00
PHST- 2014/02/21 00:00 [received]
PHST- 2014/04/02 00:00 [accepted]
PHST- 2014/03/11 00:00 [revised]
PHST- 2014/04/30 06:00 [entrez]
PHST- 2014/04/30 06:00 [pubmed]
PHST- 2015/06/03 06:00 [medline]
AID - 10.1007/s00467-014-2823-6 [doi]
PST - ppublish
SO  - Pediatr Nephrol. 2014 Oct;29(10):2005-11. doi: 10.1007/s00467-014-2823-6. Epub 
      2014 Apr 29.