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To the Editor: Dr Hébert and colleagues¹ found that a national universal leukoreduction program for red blood cell (RBC) transfusion reduced the rates of mortality and morbidity after RBC transfusions in high-risk patients. Although the authors state that RBCs transfused in the period before the introduction of the policy were stored in an additive solution, they do not indicate whether any of these units underwent depletion of the buffy coat. It also would be important to know about clinical use of microaggregate filters at the bedside.

Furthermore, RBCs that are not leukoreduced by filtration may vary in their risk of transfusion reactions. Buffy coat–depleted units contain about 70% fewer white blood cells and fewer microaggregates than does blood that has not been depleted of the buffy coat.² Blood that is neither filtered nor depleted of the buffy coat, but which is transfused through a microaggregate filter, will contain fewer platelet . . . [Full Text of this Article]

Jonathan P. Wallis, MBBS, FRCPath
Department of Haematology
Freeman Hospital
Newcastle upon Tyne, England

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