Specific Requirements

The most common reason why the specific requirement is not met is because clinical staff are not clearly communicating to the transfusion laboratory.

Incomplete details on the transfusion request means the laboratory staff will not know the need for special blood components.

Accurate communication of specific requirements between clinical staff, and from clinical staff to the laboratory is vital to ensure the patient is provided with appropriate blood components.

Irradiated components

Irradiating cellular blood components prevents the residual donor white cells in a transfused blood component from replicating and mounting an immune response against a vulnerable patient causing transfusion-associated-graft-versus-host disease (TA-GvHD).

Irradiation prevents donor T cells causing tissue and organ damage, and ultimately death in severely immunocompromised patients. Not all immunocompromised patients need irradiated blood and patient situations vary; for further information please refer to your local policies and BSH guidelines (2020).

Patient indication:

• Patients who have received T cell suppressing chemotherapy (e.g. fludarabine) please note this does NOT apply to all chemotherapy and can be dosage/underlying condition dependent; see guidelines for details;
• Intrauterine transfusion (IUT);
• Exchange transfusion for neonates;
• Neonates who have received an IUT;
• Allogeneic haemopoietic stem cell donors and recipients;
• Autologous haemopoietic stem cell transplant patients;
• Congenital T lymphocyte immunodeficiency;
• Hodgkin Lymphoma (not non-Hodgkin Lymphoma);
• Chimeric antigen receptor T-cell (CAR-T) therapy.

Component indication:

• Granulocytes administration;