Development of an in-house leukofilter for packed red blood cell units: A quasi-experimental study

BACKGROUND: Leukoreduction plays a critical role in improving the safety and efficacy of blood transfusions by minimizing transfusion-related complications and transmission of leukotropic viruses. The study explores the development of an in-house leukofilter employing CD45-conjugated iron oxide nanoparticles to magnetically separate leukocytes as an alternative to conventional methods. MATERIALS AND METHODS: A quasi-experimental study was conducted at a tertiary care hospital from September 2024 to January 2025 involving 20 packed red blood cell (PRBC) units. Iron oxide nanoparticles, synthesized using pomegranate extract, were coated with bovine serum albumin and conjugated with CD45 monoclonal antibodies using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide – n-hydroxysuccinimide chemistry. To it, a PRBC aliquot was incubated and subjected to magnetic separation. Pre- and postfiltration samples were analyzed at day 0, 14, and 28. The statistical analysis was performed using Jamovi-package of R software V14.03. A paired t -test was done to look for statistical significance. RESULTS: The mean prefiltration and postfiltration leukocyte count were 14.55 × 10 9 /L and 0.0645 × 10 9 /L (0.05 × 10 9 /L-0.08 × 10 9 /L), respectively, demonstrating an efficient and statistically significant leukoreduction of 2.35 log reduction. Red cell parameters, including hemoglobin, hematocrit, and red blood cell count, were well preserved with 0.03% hemolysis (<0.8%), and no significant changes in lactate dehydrogenase or potassium levels. Blood cultures at day 14 showed no growth, confirming that the method adheres to clinical quality standards. CONCLUSION: This innovative leukoreduction technique demonstrates effective leukocyte removal while preserving RBC integrity throughout the storage period, presenting a viable alternative for transfusion practices with potential clinical applicability in transfusion medicine.