|
Indications
for Irradiated Blood Components
Revision Effective 5/1/2006
| Category |
Some Specific Examples |
| Congenital Immunodeficiency Syndromes |
Thymic hypoplasia (DiGeorges’ Syndrome)
Wiscott-Aldrich syndrome
Lenier’s disease
5’ Nucleotidase deficiency
Nonspecified immunodeficiency
Severe Combined Immunodeficiency (SCIDS) |
| Solid Tumor Malignancies |
Neuroblastoma
Glioblastoma
Rhabdomyosarcoma
Germ Cell Tumor
|
| Hematologic Malignancies |
Hodgkin’s disease
Non-Hodgkin’s lymphoma
Acute myelocytic leukemia
Acute lymphocytic leukemia
Chronic lymphocytic leukemia
Aplastic anemia
Fludarabine treatment |
Intrauterine/Exchange Tranfusions |
All intrauterine and exhange tranfusions
All units to babies with IUT and exchange |
| HLA/Selected Donors |
HLA selected/matched
Crossmatched platelets |
| Directed Donors |
All directed donations |
| Progenitor Cell Recipients |
Bone Marrow Transplant
Stem Cell Transpant
Cord Blood Transplant |
| Patients identified as
Pediatric Oncology or "Peds Ons" |
All pediatric oncology
patients |
Prevention of Transfusion Transmitted CMV
As
of 5/1/2006, requests for CMV seronegative red cell and platelet components
will be filled using prestorage leukocyte-reduced components. Prestorage
leukocyte-reduced components have been shown to be effective in preventing
transfusion transmitted CMV.
CMV in blood
donors has been shown to be carried by leukocytes. Several studies have
shown that leukocyte reduction by current methods is highly effective
in preventing transfusion-transmitted CMV. Leukocyte reduction is equivalent
to CMV seronegativity in preventing CMV transmission. All of the cellular
blood components (red cells and platelets) currently provided by the
Blood Bank are pre-storage leukocyte reduced and subject to stringent
quality control, and thus are CMV "safe". In this environment,
CMV seronegative provides no additional benefit, but incurs extra costs.
For these reasons, we have chosen to discontinue "CMV negative"
components.
Patients with
Special Needs
With the exception of Directed
Donor units shipped from outside suppliers, all units of Red Blood Cells
and Platelets
transfused at the University of
Michigan Hospitals and Health Centers are Prestorge Leukocyte-reduced.
| Procedure |
RBC |
FFP |
PLT |
LR |
IRR |
SC |
| ECMONeonatal |
2.5 |
1 |
1 |
Y |
N |
N |
- RBC
<10 days
- 1
unit of RBC plasma removed.
- Dispense
in syringes if volume requirement is < 50ml
- Platelet
count maintained at >70,000/mm3
|
ECMO Ped/Adult |
11 |
2 |
5 |
Y |
NA |
NA |
- RBC <10 days
- Platelet count maintained at > 100,000/mm3
|
| IUT - Intrauterine Transfusion |
1-2 |
1 |
0 |
Y |
Y |
Y |
- RBC as fresh as possible <5 days
- Remove plasma from RBC
- Resuspend to a 75% Hct.
- Irradiate before removing aliquots
- Dispense in 20 mL syringes 17mL in each
|
Exchange Transfusion of Neonate |
1-2 |
1-2 |
0 |
Y |
Y |
Y |
- RBC as fresh as possible <7 days
- Resuspend to a 50% Hct
|
| Exit Procedure |
1-2 |
1 |
NA |
Y |
Y |
Y |
- RBC as fresh as possible
- Remove plasma from RBC
- Resuspend with plasma to a 50% HCT
|
| Liver TP <40 kg |
10 |
5 |
NA |
NA |
NA |
NA |
|
| Liver TP >40 kg or greater |
10 |
10 |
NA |
NA |
NA |
NA |
- KA : 5 RBC, 5 FFP, See
Proc Man. for special typing
|
| Heart, or Lung Transplant,
Heart Assist Devices |
|
|
|
Y |
N |
N |
| Renal Transplant |
|
|
|
Y |
N |
N |
KEY: IRR = Irradiated, SC = Sickle Cell Negative,
LR = Prestorage Leukocyte-reduced components,
KA = Keep Ahead
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