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Medical Services

Transfusion medicine

The presence or absence of A and/or B antigens and antibodies, as outlined in the table below, is the basis for determining ABO type compatibility between patient and donor. ABO antibodies develop naturally starting at approximately 3 months of age, whereas antibodies against Rh occur in Rh negative individuals only after exposure to Rh positive red cells via transfusion or pregnancy. When assessing the compatibility of blood and components, both patient and donor antigens and antibodies must be considered.

ABO Antigens/Antibodies Chart

Description Indication

Leukoreduction: Removal of white cells either through filtration or special collection techniques

NOTE: Leukoreduction is not indicated in components that contain no viable white cells (Plasma and Cryoprecipitate).

  • Prevention of febrile transfusion reactions
  • Reduce HLA alloimmunization with resultant platelet refractoriness or organ transplant rejection
  • Prevention of transmission of Cytomegalovirus (CMV)

CMV Seronegative: RBCs and Platelets from a Cytomegalovirus (CMV) seronegative donor.

Blood products are considered “CMV safe” if either CMV sero-negative or leukocyte reduced.

  • Premature infants, low birth weight neonates, intrauterine transfusions, neonatal exchange transfusions
  • CMV seronegative or unknown with severe immune compromise or HIV/AIDS
  • Congenital immune deficiency
  • Recipients/candidates for hematopoietic or solid organ transplant
  • Pregnancy

Irradiation: Inactivation of lymphocytes to prevent Transfusion-related Graft Versus Host Disease (TA-GVHD), a very rare, but fatal (90-100%) complication of blood transfusion.

NOTE: Irradiation is not indicated in components that contain no viable white cells (Plasma and Cryoprecipitate).

  • Neonates, intrauterine transfusions, neonatal exchange transfusions
  • Congenital immunodeficiency
  • Severe other immunodeficiency
  • Hematological malignancy
  • Hematopoietic stem cell transplant
  • Patients receiving immunosuppressive drugs
  • All Granulocytes
  • Transfusions from family members (directed donations) or HLA-selected donors

Washed Red Blood Cells and Platelets: Washing with saline to remove donor plasma. This requires BloodworksNW physician approval.

CAUTIONARY NOTE: For red cells, approximately 20% of the cells are lost. For platelets, both platelet recovery and function are severely impaired.

  • Severe, life threatening plasma allergies uncontrolled by medications or volume reduction as determined by BloodworksNW.

Volume Reduced Platelets: Removal of donor plasma.

CAUTIONARY NOTE: Approximately 10% of platelets are lost, platelets are activated and function is lost.

  • Persistent allergic transfusion reactions
  • ABO incompatibility between platelet donor and patient
  • Exquisitely sensitive to volume

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