Modifications to Blood Components

Transfusion medicine

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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