We assessed the performance of a leukocyte reduction filter, WBF2, which has been developed for preparation of blood products with pre-storage leukocyte reduction, and analyzed residual leukocyte subsets in the filtered whole blood.
Whole blood was collected from six healthy volunteer donors and filtered 4 hours after collection. Leukocyte subsets of unfiltered and filtered whole blood were analyzed by flow cytometry, and absolute cell numbers of each leukocyte subset were determined.
Total leukocyte counts per bag were 1.75±0.34×10⁹ for the unfiltered blood and 2.23±1.37×10⁴ for the filtered blood. Average log₁₀ leukocyte reduction rate was 4.83. In the filtered whole blood, the number of granulocytes, CD4+ T lymphocytes, CD8+ T lymphocytes and NK cells was 8.67±7.66×10³, 11.6±36.5×10³, 4.05±0.80×10³ and 1.66±1.35×10³, respectively. No monocytes or B lymphocytes were detected in the whole blood after filtration.
These results show that leukocyte reduction rate using the WBF2 filter varies according to leukocyte subset; in particular, monocytes and B lymphocytes are reduced more effectively by this filter.

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All immediate transfusion reactions are now recognized under an improved reports system the which combines side effect report with transfusion record. From October 1998 to April 2000, 1, 526 transfusions were conducted, with 27 cases (1.8%) experiencing immediate side effects, including 13 cases of fever, 6 of hematuria, 5 of urticaria, 1 of hypertension, 1 of vomiting, and 1 of dyspnea. seventeen of these cases used RC-MAP (total 809 transfusions), 5 whole blood (total 39), 2 fresh frozen plasma (total 398), 2 platelet concentrate (total 191), and 1 an autologous RC-MAP transfusion (total 89). The causes of side effects were identified in 14 cases. Anti-complement 4 antibody was positive in 2 cases, anti-compliment 9 antibody and anti-glycoprotein antibody were positive in 1 case, anti-HLA antibody was positive in 4 cases, transfusion was administered too rapidly in 1 case, a 50% glucose solution was included in 5 cases, and incorrect use of an infusion pump in 1 case.
In contrast to the new system, immediate adverse reactions were reported in only 11 of 4, 557 transfusions (0.2%) from April 1995 to September 1998 with the uncombined reporting system.
Combining a side effect report with the transfusion record is useful in identifying episodes of immediate adverse reactions.

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The Fukuoka Committee for Inspection and Accreditation (I & A) Program on Blood Transfusion Practice in Hospitals was founded in May 2000 as a subgroup of the Kyushu I & A committee to create the basis of actual I & A procedures. The committee consists of four medical doctors and sixteen medical technologists who are working at the blood transfusion unit of each hospital, and two medical representatives of Fukuoka Red Cross Blood Center. This committee has met six times to discuss the methods of the I & A program. Since then we have inspected four hospitals, and have been able to improve the standard manual of the I & A program and the I & A report form. Furthermore, several defects identified by the inspectors in the four inspected hospitals have been improved in accordance with the respective inspection reports. For example, one of the four hospitals that had no committee to supervise blood transfusion therapy has newly established this committee in the hospital. In the near future, we will develop an I & A program for the whole Kyushu area. Furthermore, the I & A program should be established as a routine system for appropriate blood transfusion practice throughout Japan. For this purpose, it is necessary to standardize the I & A program and improve the inspection ability of inspectors.

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