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Irradiated Blood Components

Red blood cells and platelets can be irradiated to inactivate lymphocytes and prevent transfusion associated graft versus host disease (GVHD). Leukocyte reduction does not remove sufficient numbers of lymphocytes to prevent GVHD. Plasma and cryoprecipitate do not need to be irradiated.

Irradiation does not affect cell survival or function but does damage the red blood cell membrane sodium-potassium pump, causing leakage of potassium across the cell membrane into the plasma. Plasma potassium levels increase almost twofold within 24 hours. This potassium load is not harmful to most adults, but can significantly elevate potassium levels in neonates and fetuses. This potential problem can be avoided by irradiating units just prior to transfusion.

Clinical indications for ordering irradiated blood include:

  • Recipients of allogenic and autologous hematopoietic progenitor cell transplantation
  • Children with severe congenital immune deficiency syndromes
  • Granulocyte transfusions
  • Recipients of transfusions from blood relatives
  • Treatment with purine analogue drugs (fludarabine, cladribine, deoxycoformycin)
  • Treatment with Campath (anti-CD52)
  • Treatment with anti-thymocyte globulin
  • HLA matched or partially matched platelet transfusions
  • Hodgkin’s Disease
  • Acute leukemia if patient is a transplant candidate
  • Non-Hodgkin lymphoma if patient is a transplant candidate
  • Intrauterine (fetal) transfusions
  • Neonates who received irradiated components as fetuses
  • Neonatal exchange transfusions

Administration of irradiated products is the same as the administration of non-irradiated products.

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