Role of Bedside Leukoreduction Filters in Mitigating Febrile Non-Hemolytic Transfusion Reactions in Thalassaemia Major Patients

Abstract

Objective: To evaluate the clinical effectiveness of bedside leukoreduction filters in reducing the occurrence of febrile non-hemolytic transfusion reactions (FNHTRs) among patients with beta-thalassemia major, by comparing their frequency in patients receiving blood through a filter versus those without a filter.

Methodology: A retrospective cross-sectional comparative study was conducted at the Thalassemia Centre in collaboration with the Blood Bank, Pakistan Institute of Medical Sciences, from January to March 2024. A total of 1,000 multi-transfused beta-thalassemia major patients with a history of FNHTRs were included and divided into two groups: 500 patients received blood through bedside leukoreduction filters, while 500 received non-filtered blood. Transfused red cell concentrates ranged in storage age from 2 to 14 days. Data were analyzed using SPSS Version 20, and the chi-square test was applied to compare the incidence of FNHTRs between the two groups. A p-value of <0.05 was considered statistically significant.

Results: Among the 500 patients receiving bedside leukoreduced blood, 7 (1.4%) experienced FNHTRs during transfusion, presenting with symptoms such as fever, chills, cold extremities, abdominal pain, and facial flushing. In contrast, 49 (9.8%) patients receiving non-filtered blood developed FNHTRs (p < 0.001).

Conclusion: The incidence of FNHTRs was significantly reduced with the use of bedside leukoreduction filters compared to non-leukoreduced blood. Implementing this simple and cost-effective strategy in resource-limited settings can help prevent transfusion reactions, improve patient and staff satisfaction, and reduce the risk of transfusion discontinuation, prolonged hospitalization, and extensive laboratory investigations.