Transfusion question

[Georgia peach RN]

Hi all have a question that about something that is bothering me, had a phone order taken from a nurse from another department which was - type & crossmatch give 2 units PRBCs through leukocyte reducing filter.

ok my question if the unit is leukocyte reduced from the blood bank and you have the 15 micron filter on your blood set why the need for another filter???

I have heard of these filters being used years ago but not in the last 10 yrs or so, I have never seen one, did not even know our facility had these. It isnt addressed when orietating new nurses to the facility P&P's

anyone with expertise in this area? I appreciate any insite. Thanks

[iluvivt, BSN, RN]

If the unit was leukoreduced in the Blood Bank than you generally do not need to add a special filter. You can just use your standard Y site tubing with a 170 to 200 micron filter (brand dependent). If it was not that you will need to add the leukocyte reducing filter just prior to administering the blood. My understanding is that the majority of hospitals in the US have the leukocytes removed prior to releasing the blood. The Pall ones I used to use were very annoying to prime and my understanding is it a lot cheaper per unit to do the reducing up front.

There are excpetions to this though and you can actaully have them reducred prestorage and still add one at the beside to catch any that are left. This is usally seen with neonates and pediatic patients.

There are also microaggregate filters you can use to but these do not remove leukocytes and are used when multiple transfusions are needed. These are usually 40 micron filters. The 15 micron ones I have seen have been for Albumin and IVIG though many of these are not needed due to improvement in manufacturing processes. If the manufacturer supplies it then I would use it.