Non-leukodepleted red blood cell transfusion in sepsis patients: beyond oxygenation, is there a risk of inflammation?

Donati and colleagues [1] evaluated the benefits of fresh, leukodepleted (LD) versus non-leukodepleted (nLD) erythrocyte transfusions on the microcirculation in sepsis patients. Oxygenation appeared equal in both groups. Differences between the two kinds of blood cells are presented in Table 1. In the reported study, there is a difference between the age of erythrocytes in the two groups (1.5 to 3 days for nLD versus 3.5 to 5 days for LD erythrocytes; a U test indicates P < 0.05); this suffices to influence oxygen delivery mediators (Figure 1). The content of leukocytes prior to (and after) leukodepletion were not tested, nor was the freeing which is usually very fast of secreted or docked, soluble biological response modifiers. Considering the dynamics of secreted biological response modifiers in platelet components [2], there must be differences within the two groups, which possibly