It has been over 2 years since the industrialized nations began recognizing the benefits of routine leukocyte filtration and began adopting it as a standard of practice. Globally, 10 countries have now mandated this standard of care. Canada was the first country to move to 100% leukocyte reduction. This year, Germany became the ninth European nation to date to mandate universal leukocyte reduction as a matter of public policy. Meanwhile, other countries are progressing towards leukocyte reduction without a government mandate. In the United States, progress continues with Rhode Island becoming the first state to provide 100% leukocyte reduced blood products for its health care system. Below is an alphabetical listing of those countries that have made the commitment to universal leukocyte reduction.
	Austria collects approximately 440,000 units of whole blood annually. During 1996, the Austrian Red Cross decided to introduce leukocyte reduction on clinical grounds. The blood center in Vienna, which processes 250,000 whole blood units annually, leukocyte reduces all blood by filtration. The Austrian Red Cross is now introducing leukocyte reduction by filtration into other Austrian blood banks.
	In Canada, the Canadian Blood Services (CBS) and Hema-Quebec have completed their introduction of pre-storage leukoreduction for all blood products. In 1998, following a directive issued by the Canadian Government, Canada was one of the first countries in the world to implement filtering of all platelets for transfusion.
	France committed to 100% leukocyte reduction in April 1998, both on clinical grounds and as a precautionary tool ensuring the safety of its blood supply.
	Eire announced plans to move to 100% leukocyte reduction in April 1998 as a precautionary measure against nvCJD. At that time the Medical Director of Ireland's National Blood Service, Dr. William Murphy, stated that the decision was based on the findings of experiments involving scrapie. Scrapie is a form of disease, transmissible spongiform encephalopathy, similar to nvCJD that occurs in sheep and goats. Since that time Eire has successfully implemented 100% leukocyte reduction of its transfused red cells and plasma.
	Germany has mandated routine filtration of all blood products. The Paul-Ehrlich-Institut announced its intention to make routine blood filtration mandatory last March as an added margin of safety. According to the legal notice published in the German "Bundesanzeiger", on September 14, 2000, the decision to require blood filtration was based on clinical studies demonstrating the benefits of removing donor white blood cells from transfusion products, The new law goes into effect on October 1, 2001.
	New Zealand has a 2-phase approach to its government mandated universal leukocyte reduction plan. The Phase 1 target is 100% filtration of platelets by Christmas, 2000. The Phase 2 target is for 100% blood bank filtered red blood cells by April, 2001.
	Portugal introduced filtration of all donated blood and platelets in early 1999 to reduce the risk of infection with nvCJD. Blood banks are using leukocyte reduction filters to extract white blood cells in order to reduce the potential risk of infection with nvCJD.
	United Arab Emirates (UAE) is a federation composed of seven emirates: Abu Dhabi, Dubai, Sharjah, Ajman, Umm al-Qaiwain, Ras al-Khaimah and Fujairah. The UAE has issued a tender which will allow it to move to 100% filtered collections by July 2001.
	During 1999, the United Kingdom (England, Northern Ireland, Scotland, Wales) introduced filtration of all of its blood components for transfusion, red cells, platelets and plasma. This was a move to minimize the risk of nvCJD and in response to the fact that the British government had been advised by the U.K.'s Spongiform Encephalopathy Advisory Committee (SEAC), to leukoreduce blood intended for transfusion as a precautionary measure. The U.K. government accepted SEAC's advice, commissioned a risk assessment, and instructed the National Blood Authority (NBA) to leukocyte reduce all transfused blood products to reduce the risk of transfusion complications potentially caused by contaminants carried by the leukocytes.
	In the United States, where about 13-14 million units of blood are collected annually, only about 60 to 70% of platelet components and 20% of red cells are leukocyte reduced. On September 18, 1998 the Food and Drug Administration's Blood Products Advisory Committee (BPAC) approved a recommendation that "the benefit to risk ratio associated with leukoreduction is sufficiently great to justify routine leukoreduction of all non leukocyte transfusion blood components…" As of November 2000, the American Red Cross that manages about 45% of the US blood supply was leukocyte reducing 70%. Currently, there is no national policy on leukocyte reduction in the United States.