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FDA says it might remove white blood cells from donations

Feb. 2, 2001

But procedure could make shortage worse



Amid a nationwide blood shortage, the Food and Drug Administration must make a decision between ensuring safer blood transfusions and maintaining the current amount of transferable blood.

The FDA, after a recommendation by the Department of Health and Human Services, is debating whether to order that all blood be filtered of white blood cells, which are the infection-fighting agents in blood.

The reasons for this filtration, which is called a leukocyte reduction, stems from the risk of viral and bacterial infections that could occur from the transfer of white blood cells, according to the FDA Web site. Also, patients who need transfusions usually only need red blood cells.

Despite these benefits, there are many drawbacks to filtering out white blood cells. The procedure also filters out about 10 percent of red blood cells, which is a problem when blood supply is low.

Red Cross communications manager Avonelle Chitwood said the Red Cross has distributed mainly leukocyte-reduced blood after weighing the costs and benefits and finding that having safer blood was worth the extra expenses and the sacrifice of some usable blood. Chitwood said the blood loss would not be an 'enormous amount,' and 'it's not enough that it would cause a complete shortage.'

Another problem with universal leukocyte reduction is the increased cost to hospitals and donor organizations. However, Chitwood said, 'The doctors that have tracked [leukocyte reduced transfusions] have found that those patients that have used [leukocyte reduced blood] generally have had shorter hospital stays.'

She said these shorter stays would save both the hospital and patients money.

The FDA Web site said an FDA preliminary voting committee found that 'the benefit-to-risk ratio associated with leukocyte reduction is sufficient to justify the universal leukocyte reduction' of transferable blood, and that the 'FDA supports the increased use of leukocyte reduced blood.'

However, the decision has not been finalized.

Baylor biology professor Dr. William Hillis said that, although white blood cells can carry viruses and elements that cause allergic reactions when transferred, it is not best in all situations to filter them out.

Hillis said patients who are on 'dialysis because of kidney failure have a better chance of retaining a [transplanted] kidney if they have previously been infused with blood that contains leukocytes.'

Hillis also said he's not sure what all the outcomes might be to using leukocyte reduced blood because not enough testing has been done. He said that more comparisons between transfusions with and without white blood cells need to be done.