減除白血球血品的實證醫學

Evidence-Based Medicine of Leukocyte-Reduced Blood Components

林東燦(Dong-Tsamn Lin) ； 羅仕錡(Shyh-Chyi Lo) ； 何國維(Kuo-Wei Ho) ； 侯勝茂(Sheng-Mou Hou)

《台灣醫學》 22卷2期 (2018/03) Pp. 199-204

https://doi.org/10.6320/FJM.201803_22(2).0012

摘要

輸血安全性提昇非常仰賴輸血醫學技術的持續進步，減除白血球血品的問世便是輸血安全的重要進展之一。研究顯示使用減除白血球之諸多血品能直接改善特定輸血不良反應的發生率及嚴重性，其中實證醫學有顯著效果的包含：降低巨細胞病毒(cytomegalovirus，CMV)感染風險、減少非溶血性發熱性輸血反應及預防血小板輸注無效；此外，輸血治療不良反應減少也同時反應醫療照護費用降低及病人照護品質提昇。臨床輸血治療使用減除白血球血品是一個無風險且對病人有益的治療選擇。

關鍵字

減除白血球 ； 輸血不良反應 ； 巨細胞病毒 ； 非溶血性發熱性輸血反應 ； 血小板輸注無效

並列摘要

The increasing safety of blood transfusion primarily depends on persistent improvement of transfusion medicine technology, and the development of leukocyte reduction techniques for blood components is one of the major progresses. Many studies showed the usage of various leukocyte-reduced blood components can directly reduce in the frequency and severity of some transfusion reactions. Some of them are strongly evidence-based, including reduced cytomegalovirus transfusion-transmission risk, reduction of non-hemolytic febrile transfusion reactions, and reduced incidence of platelet transfusion refractoriness. Reduction of those transfusion reactions can also lead to cost-saving and quality improvement of healthcare. For clinical transfusion, leukocyte-reduced blood components are risk-free and patient-benefit treatment choices.

並列關鍵字

leukocyte-reduced ； transfusion reaction ； cytomegalovirus ； non-hemolytic febrile transfusion reaction ； platelet transfusion refractoriness

參考文獻

Paglino JC, Pomper GJ, Fisch GS, et al: Reduction of febrile but not allergenic reactions to RBCs and platelets after conversion to universal prestorage leukoreduction. Transfusion 2004;44:16-24.

Yazer MH, Podlosky L, Clarke G, et al: The effect of prestorage WBC reduction on the rates of febrile nonhemolytic transfusion reactions to platelet concentrates and RBC. Transfusion 2004;44:10-5.

King KE, Shirley RS, Thomas SK, et al: Universal leukoreduction decreases the incidence of febrile nonhemolytic transfusion reactions to RBCs. Transfusion 2004;44:25-9.

Heddle NM, Blajchman MA, Meyer RM, et al: A randomized controlled trail comparing the frequency of acute reactions to plasma-removed platelets and prestorage WBC-reduced platelets. Transfusion 2002;42:556-66.

The Trial to Reduce Alloimmunization to Platelets Study Group: Leukocyte reduction and ultraviolet B irradiation of platelets to prevent alloimmunization and refractoriness to platelet transfusions. N Engl J Med 1997;337:1861-9.