Advances in transfusion therapy.

OBJECTIVE. To review several recent advances in blood transfusion therapy. DATA SOURCES. Professional journals and current American Association of Blood Banks (AABB) recommendations. STUDY SELECTION. Not applicable. DATA EXTRACTION. Not applicable. DATA SYNTHESIS. Improvements in leukocyte reduction of blood components have been effective in preventing alloimmunization to white cell antigens and the transmission of cytomegalovirus. Leukocyte reduction has not proved effective, however, in preventing febrile reactions after platelet transfusions in alloimmunized patients. To reduce the risk of transfusion-associated graft-versus-host disease, new recommendations for the irradiation of blood components have been made. They include the irradiation of donor units from all blood relatives of the recipient and an increase in the recommended dose of irradiation to 2,500 cGy. Current investigations of both hemoglobin-based and fluorocarbon-based blood substitutes may improve the safety and efficacy of transfusion therapy in the future. CONCLUSION. Advances in transfusion therapy include the prevention of alloimmunization to leukocyte antigens, the prevention of CMV transmission by using leukocyte-reduced blood products, the reduction of the risk of transfusion-associated graft-versus-host disease, and the investigation of potential blood substitutes.