Dilini Christina Ranasinghe: Why Leucoreduction Timing Matters in Transfusion Safety
Dilini Christina Ranasinghe, Medical Officer at the Immunohaematology Reference Laboratory of the National Blood Centre, shared a post on LinkedIn:
“Transfusion reactions may manifest at the bedside, but are often determined much earlier in the processing phase, with many reactions occuring due to donor leucocytes and their byproducts which brings into focus the role of leucoreduction.
In Sri Lanka, practice largely involves post-storage filtration at the blood bank prior to issue — as a practical approach in a resource-variable setting, balancing cost and feasibility, thus offering a controlled and standardised approach compared to bedside filtration.
However, in minimising transfusion reactions, the key distinction lies in timing.
With post-storage filtration, blood bank (pre-issue) or bedside (post-issue), leukocytes are removed after storage, when cytokines and other mediators may have already accumulated.
In contrast, pre-storage leucoreduction removes them early, reducing this process.
So while blood bank filtration offers advantages over bedside filtration in terms of quality and consistency, it still differs biologically from pre-storage leucoreduction.
Pre-storage leucoreduction is the gold standard, and moving towards universal implementation is an important goal to optimise transfusion safety and align with best practices.
Reading this article prompted me to reflect on these aspects of component processing and their impact on transfusion outcomes.
It was a useful reminder that transfusion safety is shaped not only by compatibility testing, but by decisions made throughout the entire vein-to-vein process.”
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