Template:Transfusion risk: Difference between revisions
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===Leukocyte Irradiated/Depleted RBCs<ref>Treleaven J et al. Guidelines on the use of irradiated blood components: Prepared by the BCSH Blood Transfusion Task Force. British Society for Haematology. Jan 2013. http://www.bcshguidelines.com/documents/irrad_bcsh_072010.pdf</ref>=== | |||
*Gamma or X-radiated blood components to prevent [[Transfusion-associated graft-versus-host disease]] for at risk patients | |||
*If tranfusion required for crashing patient, do not delay tranfusion of uncrossed blood to irradiate products | |||
*Requires minimum 25 Gy irradiation, not to exceed 50 Gy for all: | |||
**Packed red cells | |||
**Platelets | |||
**Granulocyte components, regardless of immunocompetency | |||
**First or second degree relatives, regardless of immunocompetency | |||
**HLA-selected components, regardless of immunocompetency | |||
*Irradiated products should be administered shortly after irradiation | |||
*Those products not used for intended recipient may be returned safely to stock for others not requiring irradiated components, though with reduced shelf life | |||
*Not necessary to irradiate FFP, cryoprecipitate, fractioned plasma products | |||
====At Risk Patients Requiring Irradiated Products==== | |||
*Congenital immunodeficiency syndromes (T-cell deficiencies) | |||
*Neonates, especially if premature | |||
*Exchange transfusions in pre-term and term infants | |||
*Intrauterine transfusions | |||
*Acquired immunodeficiencies to include: | |||
**Lymphoma | |||
**Leukemia | |||
**Aplastic anemia | |||
**Neutropenia | |||
*Patients receiving: | |||
*Stem cell transplants or harvesting | |||
**Purine analogue chemotherapies (fludarabine, cladribine, deoxycoformicin, bendamustine, clofarabine, etc.) | |||
**Certain biologic immunosuppresants (alemtuzumab) | |||
====Not Routinely Needing Irradiated Products==== | |||
*HIV, AIDS | |||
*Concurrent, non-severe common viral infection | |||
*Rituximab treatment | |||
*Routine solid organ transplant | |||
*Routine infant cardiac surgery | |||
Revision as of 01:42, 20 August 2016
Transfusion Risk Ratios[1]
| Rate | Complication |
| 1:10 | Febrile non-hemolytic transfusion reaction per pool of 5 donor units of platelets (1 pack) |
| 1:100 | Minor allergic reactions (urticaria) |
| 1:300 | Febrile non-hemolytic transfusion reaction per unit of RBC (1 pack) |
| 1:700 | Transfusion-associated circulatory overload per transfusion episode |
| 1:5,000 | Transfusion-related acute lung injury (TRALI) |
| 1:7,000 | Delayed hemolytic transfusion reaction |
| 1:10,000 | Symptomatic bacterial sepsis per pool of 5 donor units of platelets |
| 1:40,000 | Death from bacterial sepsis per pool of 5 donor units of platelets |
| 1:40,000 | ABO-incompatible transfusion per RBC transfusion episode |
| 1:40,000 | Serious allergic reaction per unit of component |
| 1:82,000 | Transmission of hepatitis B virus per unit of component |
| 1:100,000 | Symptomatic bacterial sepsis per unit of RBC |
| 1:500,000 | Death from bacterial sepsis per unit of RBC |
| 1:1,000,000 | Transmission of West Nile Virus |
| 1:3,000,000 | Transmission of HTLV per unit of component |
| 1:3,100,000 | Transmission of hepatitis C virus per unit of component |
| 1:4,700,000 | Transmission of HIV per unit of component |
Leukocyte Irradiated/Depleted RBCs[2]
- Gamma or X-radiated blood components to prevent Transfusion-associated graft-versus-host disease for at risk patients
- If tranfusion required for crashing patient, do not delay tranfusion of uncrossed blood to irradiate products
- Requires minimum 25 Gy irradiation, not to exceed 50 Gy for all:
- Packed red cells
- Platelets
- Granulocyte components, regardless of immunocompetency
- First or second degree relatives, regardless of immunocompetency
- HLA-selected components, regardless of immunocompetency
- Irradiated products should be administered shortly after irradiation
- Those products not used for intended recipient may be returned safely to stock for others not requiring irradiated components, though with reduced shelf life
- Not necessary to irradiate FFP, cryoprecipitate, fractioned plasma products
At Risk Patients Requiring Irradiated Products
- Congenital immunodeficiency syndromes (T-cell deficiencies)
- Neonates, especially if premature
- Exchange transfusions in pre-term and term infants
- Intrauterine transfusions
- Acquired immunodeficiencies to include:
- Lymphoma
- Leukemia
- Aplastic anemia
- Neutropenia
- Patients receiving:
- Stem cell transplants or harvesting
- Purine analogue chemotherapies (fludarabine, cladribine, deoxycoformicin, bendamustine, clofarabine, etc.)
- Certain biologic immunosuppresants (alemtuzumab)
Not Routinely Needing Irradiated Products
- HIV, AIDS
- Concurrent, non-severe common viral infection
- Rituximab treatment
- Routine solid organ transplant
- Routine infant cardiac surgery
- ↑ Wagner, L. Why Should Clinicians Be Concerned about Blood Conservation? ITACCS. 2005 PDF
- ↑ Treleaven J et al. Guidelines on the use of irradiated blood components: Prepared by the BCSH Blood Transfusion Task Force. British Society for Haematology. Jan 2013. http://www.bcshguidelines.com/documents/irrad_bcsh_072010.pdf