[Clinical evaluation of various preventive methods for non-hemolytic transfusion reactions]. / Evaluation clinique de différentes méthodes préventives des réactions transfusionnelles non hémolytiques.

A study has been carried out on the incidence of non-hemolytic transfusion reaction on a group of patients suffering from thalassemia. Of this group, the rate of reactions per patient, based on the relationship between the number of patients with non-hemolytic transfusion reactions and the total number had risen to 31.8%. 83.7% of the patients with non-hemolytic transfusion reactions did not give a positive reaction to lymphocytotoxicity. 654 patients having, or not having shown a non-hemolytic transfusion reaction received washed red cell concentrates prepared extemporaneously. This process allowed the rate of reaction per patient to drop to 3.9%. The transfusion of deleucocytated red cell concentrates by filtration, carried out on a group of 188 patients, made the rate of reaction per patient drop to 2.8%. As regards to rate reaction per patient, there is no significant difference statistically between these two groups, however, it must be pointed out that the administration of filtered red cell concentrates, by deleucocytation, notably improves the incidence of a feverish reaction, while the administration of washed red cell concentrates has an important impact on allergic reactions. Interestingly, in solution, the washed red cell concentrates have the added advantage of having only very small quantities of free iron or vasoactive proteic derivatives. The new four bag system, now allows us to collect, separate and wash in a closed circuit. Compared to the traditional method this system has the advantage of assuring greater efficiency and security. In conclusion, for the first time, the administration of washed red cell concentrates on patients who receive regular transfusions, may represent a good procedure, combined or not with deleucocytation by filtration, as to prevent the occurrence of non-hemolytic reactions.