MODIFIED BLOOD COMPONENTS

Leukocyte Reduced: United Blood Services routinely provides leukocyte reduced RBC and platelet components. Leukocyte reduced products decrease the risk of transfusion-transmitted CMV infection, the incidence of HLA alloimmunization, and the frequency of febrile nonhemolytic transfusion reactions (FNHTR). An occasional special unit (e.g., autologous or HLA matched unit imported from another center or a deglycerolized RBC) may not be leukocyte reduced. If the unit is required to be transfused as leukocyte reduced then the transfusion facility must use a leukocyte reduction filter.

Irradiated: Patients at risk for developing transfusion-associated graft-versus-host disease should receive irradiated cellular component. Examples include but may not be limited to the following:

  • Congenital immunodeficiency
  • Hematopoetic cell transplant candidates and recipients
  • Intrauterine transfusions or neonatal exchange transfusions
  • Premature infants
  • Patients receiving components from blood relatives
  • Patients receiving HLA matched or crossmatched platelets
  • Patients receiving granulocytes
  • Patients on purine analogs for hematologic or rheumatologic diseases (fludarabine, etc.)

Irradiated RBCs have an expiration date of 28 days from irradiation. If the unit has an expiration date less than 28 days prior to irradiation the shorter date must be used.

Volume Reduced: Removal of excess donor plasma from cellular components may be indicated in patients who cannot tolerate the full volume and in certain other clinical scenarios. The extra centrifugation step will cause some platelet activation and loss of function. Volume Reduced platelets have a 4 hour expiration date.

Washed: Certain clinical situations, including severe life threatening allergies to elements in plasma may require the use of washed RBCs and Platelets. The cellular products are generally resuspended in saline, with very little plasma proteins remaining. Washed RBCs have a 24 hour expiration date and there is red cell loss. The recovery and function of platelets after washing are impaired and they outdate in 4 hours.

Deglycerolized: RBCs may be frozen up to 10 years when their antigen makeup is considered ‘rare’ or for other special reasons. When a transfusion service requests antigen negative blood not found in liquid units, frozen units may be available. Through a process of deglycerolization, the cells are thawed and resuspended in saline. Deglycerolized RBCs have a 24 hour expiration date if prepared in an open system. If prepared in a closed system, deglycerolized RBCs have a 2 week expiration date.

CMV sero-negative: CMV sero-negative cellular components are provided upon request. Both leukoreduced blood and CMV sero-negative blood have been shown to reduce the risk of transmitting CMV infection through transfusion. However, breakthrough cases have been reported using both methods.

Hemoglobin S negative: Patients with Sickle Cell Disease should be given Hemoglobin S negative RBCs.