Universal leukoreduction of cellular blood components in 2001? Yes.

During the past 100 years, transfusion medicine has focused on introducing improvements in technology to increase the safety of blood transfusion. The initial obstacle to safe transfusion was the problem of acute hemolysis. 1,2 During the first 8 decades of the 20th century, much attention was given to compatibility testing, such that, by the latter decades, incompatible transfusions became increasingly uncommon. At the present time, it is estimated that an incompatible transfusion resulting in an acute hemolytic reaction occurs with a frequency of approximately 1:100,000, and a fatal hemolytic transfusion reaction with a frequency of less than 1:1,500,000. 3 In most instances, the cause is not a technical failure, but a clerical error. 4,5 In the period from 1960 to 1980, some attention was given to minor processing steps in the manufacture of different components from whole blood donation. These processes used to separate blood components were simple " centrifugational " steps, which were easily performed in hospital laboratories or regional blood centers. Thus, by the early 1980s, a substantial majority of all blood products were transfused as components, some stored in an additive solution , and others in anticoagulated plasma. 6,7 In the past 20 years, emphasis has shifted from compatibility testing and component manufacture to reducing the risk of infectious disease transmission by blood transfusion, with most effort addressing the risk of viral disease transmission by blood transfusion. The evolution of the AIDS epidemic in the early 1980s had a profound effect on blood transfusion practice , particularly with regard to manufacturing. 8,9 Before 1980, only 2 tests were performed routinely on blood donations to detect infectious agents (syphilis serology and hepatitis B surface antigen). Since 1980, 9 new tests have been introduced , all with the intent of reducing the transmission of HIV-1 and HIV-2, hepatitis C virus, and human T-lymphotropic virus (HTLV)-I and HTLV-II. This recent emphasis on reducing viral disease transmission has been as successful as the reduction in hemolytic reactions that occurred during the first 8 decades of the 20th century. The residual risk of transmitting a viral disease by blood transfusion , which causes significant morbidity or mortality in a recipient, is certainly less than 1:100,000; current estimates for the risk of hepatitis C virus infection from a single blood component in the era of nucleic acid testing are on the order of 1:900,000 and are less than 1:1,000,000 for HIV-1. 10,11 Thus, …