Transfusion of prion-filtered red cells does not increase the rate of alloimmunization or transfusion reactions in patients: results of the UK trial of prion-filtered versus standard red cells in surgical patients (PRISM A)

Br J Haematol. 2013 Mar;160(5):701-8. doi: 10.1111/bjh.12188. Epub 2013 Jan 7.

Abstract

This study, conducted for the UK Blood Transfusion Services (UKBTS), evaluated the clinical safety of red cells filtered through a CE-marked prion removal filter (P-Capt™). Patients requiring blood transfusion for elective procedures in nine UK hospitals were entered into a non-randomized open trial to assess development of red cell antibodies to standard red cell (RCC) or prion-filtered red cell concentrates (PF-RCC) at eight weeks and six months post-transfusion. Patients who received at least 1 unit of PF-RCC were compared with a control cohort given RCC only. About 917 PF-RCC and 1336 RCC units were transfused into 299 and 291 patients respectively. Twenty-six new red cell antibodies were detected post-transfusion in 10 patients in each arm, an overall alloimmunization rate of 4.4%. Neither the treatment arm [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.3, 2.5] nor number of units transfused (OR 0.95, 95% CI 0.8, 1.1) had a significant effect on the proportion of patients who developed new alloantibodies. No pan-reactive antibodies or antibodies specifically against PF-RCC were detected. There was no difference in transfusion reactions between arms, and no novel transfusion-related adverse events clearly attributable to PF-RCC were seen. These data suggest that prion filtration of red cells does not reduce overall transfusion safety. This finding requires confirmation in large populations of transfused patients.

Publication types

  • Controlled Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adsorption
  • Aged
  • Aged, 80 and over
  • Blood Group Antigens / immunology
  • Blood Group Incompatibility / epidemiology
  • Blood Group Incompatibility / etiology
  • Blood Loss, Surgical
  • Blood Safety / instrumentation
  • Blood Safety / methods*
  • Elective Surgical Procedures
  • Erythrocyte Transfusion / adverse effects
  • Erythrocyte Transfusion / methods*
  • Female
  • Filtration
  • Humans
  • Immunization
  • Isoantibodies / biosynthesis
  • Isoantibodies / blood
  • Male
  • Middle Aged
  • Prion Diseases / prevention & control*
  • Prion Diseases / transmission
  • Prions*
  • Resins, Synthetic
  • Sorption Detoxification / instrumentation
  • Sorption Detoxification / methods*

Substances

  • Blood Group Antigens
  • Isoantibodies
  • Prions
  • Resins, Synthetic