Immunocompromised patients, and specifically:

Deranged Physiology » Required Reading » Haematology and Oncology

Lymphoma
Irradiated blood products Stem cell transplants
Aplastic anaemia
Immunocompetent patients receiving donated blood from
relatives

e contents and properties of packed red blood cells, the Anyone receiving granulocyte transfusions

physiology of acute haemorrhage and the physiological Anyone receiving HLA-matched platelets

responses to blood transfusion are detailed in other Any neonates and any intrauterine transfusions

chapters.
How much radiation to give? e NZBLOOD transfusion
Irradiated blood products arecomponents of whole blod
medicine handbook recommends a minimum dose of 25 Gy
which have been exposed to high doses of ionising radiaton,
to the centre of the container. One should not exceed 50Gy,
so as to cripple the lymphocytes they accidentally contain.
as one may harm useful blood components and end up with
e consequence of leaving the lymphocytes in situ is the
a damaged bag of packed cells.
dreaded transfusion-associated gra versus host disease
(TA-GVHD), which (on top of the delightful gut and lung
problems) also seems to cause massive bone marrow Previous chapter: Storage
hypoplasia, and is associated with a 90% mortality. lesions of banked red
blood cells
Australia does not seem to have any specific circulated
consensus publication about these products, but the British Next chapter:
have issued a guideline statement in 2011. at said, the Leukodepleted blood
Australian Red Cross has a page where one can review the products
locally accepted indications for irradiated blood products.
eir guidelines can be summarised and tabulated as
follows: References

Indications for Irradiated Blood Products Goodnough, Lawrence T., Jerrold H. Levy, and Michael F.
Murphy. "Concepts of blood transfusion in adults." The
Lancet 381.9880 (2013): 1845-1854.
Spahn, Donat R., and Lawrence T. Goodnough. "Alternatives
to blood transfusion." The Lancet 381.9880 (2013): 1855-1865.
ere is also a rescinded document from the NHMRC (2001)
which has been used to guide practice: Clinical Practice
Guidelines on the Use of Blood Components.
To some extent this document has been superceded by the
Australian and New Zealand Society of Blood Transfusion
GUIDELINES FOR THE ADMINISTRATION OF BLOOD
PRODUCTS.
e Patient Blood Management Guidelines from the
National Blood Authority of Australia is another series of
documents worth looking at - it contains several important
modules which have been reviewed and which act as
successors to the 2001 NHMRC guidelines.
Treleaven, Jennie, et al. "Guidelines on the use of irradiated
blood components prepared by the British Commiee for
Standards in Haematology blood transfusion task
force." British Journal of Haematology 152.1 (2011): 35-51.
Aoun, Elie, et al. "Transfusion‐associated GVHD: 10 years’
experience at the American University of Beirut—Medical
Center." Transfusion 43.12 (2003): 1672-1676.
Heddle, Nancy M., and Morris A. Blajchman. "e
leukodepletion of cellular blood products in the prevention
of HLA-alloimmunization and refractoriness to allogeneic
platelet transfusions [editorial]." Blood 85.3 (1995): 603-606.
Sharma, R. R., and Neelam Marwaha. "Leukoreduced blood
components: Advantages and strategies for its
implementation in developing countries."Asian journal of
transfusion science 4.1 (2010): 3.
Dzik, Walter H. "Leukoreduction of blood
components." Current opinion in hematology 9.6 (2002): 521-
526.
Corwin, Howard L., and James P. AuBuchon. "Is
leukoreduction of blood components for
everyone?." JAMA 289.15 (2003): 1993-1995.
Blajchman, M. A. "e clinical benefits of the
leukoreduction of blood products."Journal of Trauma-
Injury, Infection, and Critical Care 60.6 (2006): S83-S90.
Rosenbaum, Lizabeth, et al. "e reintroduction of
nonleukoreduced blood: would patients and clinicians
agree?." Transfusion 51.12 (2011): 2739-2743.
Bilgin, Y. M., L. M. van de Watering, and A. Brand. "Clinical
effects of leucoreduction of blood transfusions." Neth J
Med 69.10 (2011): 441-450.
Australian Red Cross - Blood Service Policy on "e Age of
Red Cells"
Hess, John R. "Red cell changes during storage." Transfusion
and Apheresis Science 43.1 (2010): 51-59. [Submit a comment or correction]

Benne-Guerrero, Ellio, et al. "Evolution of adverse

changes in stored RBCs."Proceedings of the National
Academy of Sciences 104.43 (2007): 17063-17068.
© Alex Yartsev
2013-2024