Effectiveness of buffy coat leucoreduced packed red blood cells in decreasing febrile non-hemolytic transfusion reactions in thalassemic patients

Background: Blood transfusions have always been associated with a number of adverse outcomes which have steadily decreased over years owing to new discoveries and technical advancements. Thalassemic patients are more prone to transfusions related complications owing to repeated transfusions. Study of these reactions and correlating them with the leucodepletion status of the transfused packed red blood cells (PRBCs) reduces transfusion complications due to the transfused leukocytes.Methods: This is a prospective study carried out on 1750 transfusions in 138 thalassemic patients at our institute between August 2015 and March 2016. The total transfusions were classified into four categories depending on the leucodepletion status of the PRBC’s. The clinical records and the reaction workup done to rule out the hemolytic reactions were recorded.Results: Reactions were recorded in 17 (0.97%) out of a total of 1750 transfusions. 14 (4.1%) reactions were recorded on transfusions of non-leukoreduced PRBCs whereas only 2 (0.16%) reactions were recorded in leucoreduced (buffy coat) PRBCs. 1 (0.8%) reaction was recorded on transfusion of leucodepleted PRBCs done by bedside filter. No reaction was documented when buffy coat leucoreduced PRBCs were used along bedside filter.Conclusions: Elimination of WBCs from donor packed cells results in reduction of adverse reactions following blood transfusion. Various methods of leucoreduction have been successfully employed in the past and shown to reduce transfusion reactions in multi transfused thalassemic patients. In resource limited settings, leukoreduction using the buffy-coat method is an effective intervention in reducing the transfusion reactions.