MODIFIED BLOOD COMPONENTS

Leukocyte Reduced: United Blood Services routinely provides leukocyte reduced RBC and platelet components. 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 graft-versus-host disease should receive irradiated cellular components:

• Severely immunocompromised patients
• Hematopoetic cell transplant candidates and recipients
• Patients undergoing intrauterine transfusions
• Recipients of donor directed components from a blood relative of the recipient
• If the donor is selected for HLA compatibility by typing or crossmatching
• Patients receiving fludarabine for oncologic and rheumatologic diseases

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 is indicated in patients who cannot tolerate the full volume or when ABO incompatible single donor platelets are transfused. Volume reduction may be helpful for patients with persistent febrile transfusion reactions. Approximately 10% of platelets are lost in this process and the extra centrifugation step may cause some platelet activation and loss of function. Volume Reduced platelets have a 4 hour expiration date.

Washed: Patients with severe life threatening plasma allergies uncontrolled by medications or volume reduction may require use of washed RBCs and Platelets. The units are suspended in saline, with very little plasma proteins remaining. Washed RBCs have a 24 hour expiration date. The recovery and function of platelets after washing are severely impaired. Washed platelets have a 4 hour expiration date.

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 suspended in saline for transfusion. Deglycerolized RBCs have a 24 hour expiration date.

CMV sero-negative: CMV sero-negative cellular components are provided upon request. Both leukoreduced blood and CMV sero-negative blood have a much-reduced risk of transmitting CMV infection through transfusion.

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