Template:Leukocyte Irradiated and Reduced (Depleted) Blood Products
Contents
Leukocyte Irradiated and Reduced (Depleted) Blood Products[1]
- Leukocyte reduced: Prevents sensitization in patients who may require bone marrow transplant
- Irradiated: Eliminates capacity of T-cells to proliferate (prevents Transfusion-associated graft-versus-host disease)
- If tranfusion required for crashing patient, do not delay tranfusion of uncrossed blood to irradiate products beforehand
- 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
Generally Accepted Indications For Irradiated Blood Products[2][3]
- Immunocompromised stem cell recipients
- Organ transplant recipients
- Patients undergoing marrow transplantation
- Intrauterine transfusion
- Neonatal exchange transfusions
- Premature and low birthweight neonates
- Hodgkin lymphoma
- Congenital cell-mediated immunodeficiencies (DiGeorge, Wiskott-Aldrich, Leiner's, 5'-nucelotidase deficiency)
- Acquired immunodeficiencies to include:
- Leukemia, CLL
- Aplastic anemia
- Neutropenia
- Patients receiving:
- Purine analogue chemotherapies (fludarabine, cladribine, deoxycoformicin, bendamustine, clofarabine, etc.)
- Certain biologic immunosuppresants (alemtuzumab)
- Donations from biologic relatives
- Donations from HLA-matched donors
- Genetically homogenous populations
- Probably indicated int:
- Hematologic malignancies other than Hodgkin lymphoma
- Solid tumors treated with cytotoxic agents
Indications For Leukoreduced Blood Products[4]
- Chronically transfused
- Cardiac surgery
- Solid organ or stem cell transplant recipients, before and after
- Previous febrile nonhemolytic transfusion reactions
- CMV seronegative patients at risk
Not Routinely Needing Irradiated Products
- HIV, AIDS
- Concurrent, non-severe common viral infection
- Rituximab treatment
- Routine solid organ transplant
- Routine infant cardiac surgery