Preparation of white cell‐reduced red cells by filtration: comparison of a bedside filter and two blood bank filter systems

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Abstract
Concern has been raised about the quality of white cell (WBC)-reduced red cells (RBCs) obtained by bedside filtration. The bedside performance and workload of a routine bedside filter have been compared to the laboratory performance and workload of two blood bank filter systems. Buffy coat-depleted saline-adenine-glucose-mannitol (SAGM) RBCs (90 units) were prepared. Thirty units were filtered with each of the two blood bank filter systems, and 30 units were filtered (but not transfused) with the bedside filter in a clinical department after 8 to 24 days of storage. The RBCs lost and the postfiltration WBC content (Nageotte chamber) were determined for all filtered units, and the workload associated with filtration by each of the filter systems/filter was assessed. Units with a postfiltration content of > or = 2 x 10(6) WBCs were regarded as filtration failures. Four (13%) of the 30 units filtered at the bedside were filtration failures, compared to no failures with either of the blood bank filter systems. In addition, the median WBC content (0.14 x 10(6)) of the units filtered at the bedside (2 units/filter) was significantly higher than that of the units filtered in the blood bank (0.05 x 10(6)). The RBC loss was significantly higher with the filter systems than with the bedside filter, provided 2 units per filter were processed with the latter. The timed workload of the filter systems was 45 to 75 minutes per 12 units, which was similar to the time required for bedside filtration. Bedside filtration of 2 units of stored buffy coat-depleted SAGM RBCs per filter resulted in a higher incidence of filtration failure and higher postfiltration WBC content than did laboratory filtration of 1 unit of fresh buffy coat-depleted SAGM RBCs per filter with either of two blood bank filter systems.