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Transfusion support in transplantation
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
Darrell J Triulzi, Ileana López-Plaza
The amount of allogeneic marrow harvested for transplantation depends on the patient’s body weight. For most marrow donors, red blood cell requirements can be met by preharvest autologous blood donation. When both the recipient and the donor are CMV-seronegative, allogeneic transfusions should be with CMV-seronegative or filtered (CMV-safe) components. Allogeneic transfusions for the stem cell donor should be irradiated to avoid the theoretical risk of TA-GvHD by the passive transfer of immunocompetent lymphocytes from a third person at the time of transplantation to the recipient.112 Leukoreduction of cellular blood products for the donor is not routinely necessary unless filtered products are being used as a substitute for CMV-seronegative products. Donors from whom the hematopoietic stem cells are harvested by PBPC collection rarely if ever require transfusion support. If transfusion support were needed, the guidelines already described for marrow donors would apply.
Transfusion of blood components in a stem cell transplant programme
Published in Cut Adeya Adella, Stem Cell Oncology, 2018
A different issue to consider is whether leukoreduction is an option, or not. With leu- koreduction, the white blood cell count will be below one million cells per unit of platelets and erythrocytes. Leukoreduction decreases the likelihood of FNHTR and potentially subsequent antibody (e.g. anti-HLA) formation. Leukoreduction cannot be achieved by washing the component.
Transfusion therapy in injured children
Published in David E. Wesson, Bindi Naik-Mathuria, Pediatric Trauma, 2017
There are a variety of modifications that can be made to cellular products (RBCs and platelets). These include leukoreduction, irradiation, washing, and volume reduction. Leukocyte reduction has become a nearly universal practice in large blood centers and reduces the risk of febrile nonhemolytic transfusion reactions (FNHTRs) and human leukocyte antigen (HLA)-alloimmunization. Leukocyte-reduced units are considered to be cytomegalovirus (CMV) safe. Irradiation is indicated in selected populations to prevent transfusion-associated graft versus host disease, a nearly universally lethal complication of blood transfusion that may occur in immunocompromised patients or in patients receiving products from HLA-matched or related donors. Washing and volume reduction can be used in volume-sensitive patients, and may be beneficial in those with repeated transfusion reactions. In addition, certain patient populations, such as sickle cell or thalassemia patients, are issued blood products that are matched for RBC antigens, commonly Rh (D, C, c, E, and e) and K antigens. Each of these modifications requires additional time for product preparation and release from the transfusion service. In patients requiring blood products urgently, it is unlikely that there will be adequate time for modification or matching. Immediate transfusion therapy should therefore take precedence in the setting of hemorrhagic shock and should not be delayed. This may require that emergency-release units be used.
Risk factors, management and prevention of transfusion-related acute lung injury: a comprehensive update
Published in Expert Review of Hematology, 2019
Susan A. Kuldanek, Marguerite Kelher, Christopher C. Silliman
Standard leukoreduction filters are expected to reduce leukocytes in RBC and apheresis platelet units to <5.0 x106 cells per unit, which translates to a 3 log reduction of leukocytes and a 2 log reduction of platelets [32]. Standard filtration also reduces HLA antigen exposure, cytokine accumulation, CMV transmission and sCD40L accumulation in stored RBCs [14,109]. An experimental filtration paper for pre-storage leukoreduction (LR), containing standard LR material and a proprietary material designed to remove antibodies and immunoglobulins in both small volume and standard volumes, was tested for its ability to reduce the proinflammatory activity of stored RBCs [124]. Blood was donated from 31 multiparous females donors with known HLA class I and/or class II antigens and 16 control donors negative for antibodies. They found that the experimental filter successfully removed >96% of IgG, 93% of anti-HLA I antigen and 99% of anti-HLA II antigen antibodies [124]. The supernatant from RBCs that underwent experimental LR resulted in reduced PMN priming activity, specifically lipid priming, compared to the standard LR model [124]. The supernatant that underwent LR with the experimental filter also caused less TRALI in a rat-model when compared with non-LR control RBC supernatant [124].
Prevalence of G6PD deficiency in Thai blood donors, the characteristics of G6PD deficient blood, and the efficacy of fluorescent spot test to screen for G6PD deficiency in a hospital blood bank setting
Published in Hematology, 2022
Phinyada Rojphoung, Thongbai Rungroung, Usanee Siriboonrit, Sasijit Vejbaesya, Parichart Permpikul, Janejira Kittivorapart
There are three types of red cells products available in Thailand. The whole blood units were centrifuged and separated into packed red cells (PRC) and platelet-rich plasma. After 100 ml of SAGM was added into PRC, the products were labeled as red cells in additive solution (AS-RBC). The second type of RBC was prepared by leukofiltration of the AS-RBC and labeled as pre-storage filtered blood (PFB). Lastly, the leukocyte poor blood (LPB) was leukoreduction by the method of centrifugation to separate RBC from the buffy coat and the platelet-poor plasma.
The P50 value detected by the oxygenation-dissociation analyser and blood gas analyser
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2020
Zongtang Chu, Ying Wang, Guoxing You, Quan Wang, Ning Ma, Bingting Li, Lian Zhao, Hong Zhou
Blood collection and storage were performed as previously described by Wang et al. [31]. Briefly, blood was withdrawn via the carotid artery and mixed with CPDA-1 to yield a final concentration of 14% CPDA-1. Blood was leukoreduced by passage through a leukoreduction filter (BengBu Medical College, BengBu, China), centrifuged for 15 min at 400 × g to remove the supernatant, and stored at 4 °C.