NATIONAL
111S00301
BLOOD COMPONENT DATASHEET
WHOLE BLOOD PLASMA REDUCED
LEUCOCYTE DEPLETED
COMPONENT DESCRIPTION
This component is prepared by leucodepleting fresh whole blood and removing a
proportion of plasma. It is designed for use for neonatal exchange transfusions and
large volume transfusion in neonates but it can also be used for adult transfusion.
QUALITY SPECIFICATIONS
Volume:
Leucocyte Count:
Haematocrit:
Anticoagulant:
CMV Status:
High titre anti A or B:
250 – 450 mls (usually 350mls)
<5 x 106 per unit
0.45 – 0.55
CPD
On demand*
Negative
Supernatant Hb:
Fibrinogen:
Factor VIIIc:
Platelet Count:
pH at out date:
N/A
N/A
N/A
N/A
N/A
*Components for neonatal exchange transfusion should be CMV negative.
USES
To increase tissue oxygenation, when this is critically reduced by either loss of blood
or anaemia of other origin. This is the product of choice for neonatal exchange
transfusion.
DOSAGE AND ADMINISTRATION
Dosage
Dosage depends on the clinical need of the patient and it must be adjusted
accordingly.
Neonatal Exchange Transfusion: Indicated in infants born with clinically significant
anaemia with or without hyperbilirubinaemia due to haemolytic disease of the
newborn or other causes. Only units less than 5 days old should be used for this
purpose.
Anaemia: A transfusion of 4-5 ml per kg will increase the circulating haemoglobin
by about 10 g/l.
Administration
Prepared by: Susanta Ghosh
Authorised by: Peter Flanagan
QA Approved by: Nick Smith
Effective Date: 11/01/02
Copy No:
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File Name: 111S00301
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NATIONAL
111S00301
Blood to be transfused must be tested to ensure compatibility with patient’s serum
except in life threatening emergencies. For neonatal exchange transfusions it should
be compatible with neonatal serum and maternal serum if available. It must be
transfused intravenously through a blood giving set with an in-line, 170-200 micron
filter. If a syringe is used it should be filled through a filter assembly.
Patient’s vital signs should be monitored during the transfusion. In cases where
large volume of transfusion is given in a short time or where recipient’s plasma
contains significant cold acting antibodies, a blood warmer should be used.
Otherwise this preparation can be transfused without warming. The transfusion rate
depends on the clinical need but transfusion of each unit should be completed within
4 hours.
Transfusion of every unit of red cells must be preceded by adequate checking
procedures that ensure the unit to be transfused has been issued for the patient who
is to receive it and that the integrity of the bag has been maintained.
It is a legal requirement that all details of the blood component which is infused are
documented in the patient’s notes (eg, product pack number, ordering medical
officer, duration of infusion, given by, checked by, time started).
CONTRAINDICATIONS, WARNINGS, ADVERSE REACTIONS
Contraindications
Red cells must be transfused with extreme caution in patients with expanded plasma
volume, heart failure or with hyperviscosity states.
Cellular blood products should be irradiated before transfusion for patients with
profound cellular immune-deficiency or those receiving a transfusion from genetically
related donors.
Warning
Acute transfusion reactions may occur if incompatible, wrongly stored or bacterially
contaminated red cell preparations are transfused. Non-haemolytic transfusion
reactions can present as urticaria, fever and rarely as anaphylaxis. Symptoms
include chills, rigors, fever, chest tightness and hypotension. The transfusion should
be stopped immediately and the cause investigated. The implicated component
together with the recipient’s blood sample should be returned to the blood bank.
Adverse Reactions
These may be immediate or delayed.
Immune: Transfusion of ABO incompatible blood may result in acute and severe
haemolysis with shock. Transfusion of red cells may lead to immunisation to red cell
antigens. When this happens, difficulties may arise in providing compatible blood for
later transfusions. Antibodies not detectable at compatibility testing may cause
haemolysis some days after transfusion. On rare occasions such haemolysis may
be acute. Transfusion of red cells that lead to immunisation to Rh(D) or other red
cell antigens may cause or aggravate haemolytic disease of the newborn in
subsequent pregnancies in female patients.
Prepared by: Susanta Ghosh
Authorised by: Peter Flanagan
111S00301
QA Approved by: Nick Smith
Effective Date: 11/01/02
Copy No:
Page 2 of 3
File Name:
Previous File: N/A
NATIONAL
111S00301
Immunisation to leucocyte antigens and platelet antigens can make the patient
refractory to subsequent platelet transfusions. Immunisation to platelet antigens can
also cause thrombocytopenia in susceptible individuals. Immunisation to various
other non-red cell antigens is associated with non-haemolytic transfusion reactions.
Cytokines present in stored blood also can cause non-haemolytic transfusion
reactions. These complications are rather infrequent with leucodepleted red cell
preparations.
Transfusion related lung injury might occur if antibodies to recipient’s granulocytes
are present in donor plasma.
Transfusion of non-irradiated red cells can cause graft versus host disease in
patients with cellular immune-deficiency or if transfused to a genetically related
patient.
Haemodynamic:
overload.
Transfusion of excessive volumes may lead to circulatory
Metabolic: Rapid transfusion of large volume of red cells may lead to hypothermia
or hyperkalaemia. Transfusion of stored red cells may effect acid base balance in
critically ill patients. Hypokalaemia may arise about 24 hours after a large volume
transfusion.
Infective: Every care is taken in donor selection and in blood collection, processing
and storage but there is a small but definite risk of transmitting bacterial, viral and
other infections.
Reaction due to bacterially contaminated red cells usually develops within minutes
and consists of chills, rigors, fever, nausea, vomiting, abdominal and muscle pains,
hypotension, haemoglobinaemia and DIC. Recipients showing signs and symptoms
consistent with a septic reaction should be treated for septic shock before laboratory
results are available. Appropriate support for haemostatic failure may be required.
STORAGE AND PRECAUTIONS
Store at +2 °C to +6 °C. Do not use if the bag is damaged, if the product is
discoloured, or if there is a clot present. No drugs or additives other than 0.9 %
Sodium Chloride intravenous infusion may be mixed with red cells before or during
transfusion. Discard all used or partially used bags. All unused bags should be
returned to the Blood Bank. Avoid skin contact with this preparation.
FURTHER INFORMATION
Each unit conforms to the NZBS specification for donor selection and collection
procedure. Each unit has tested negative for HBsAg, Anti-HIV-I and -II, anti-HCV
and Syphilis. This component has also tested negative for HCV and HIV RNA using
NAT method.
Prepared by: Susanta Ghosh
Authorised by: Peter Flanagan
111S00301
QA Approved by: Nick Smith
Effective Date: 11/01/02
Copy No:
Page 3 of 3
File Name:
Previous File: N/A