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Irradiated components are units of whole blood, RBCs, platelets, and granulocytes that have been gamma irradiated with a dose of 25 Gy to the central portion and a minimum dose of 15 Gy to any portion of the unit. Each component must be labeled with a radiation sensitive label to indicate that an adequate dose of irradiation has been given. Gamma irradiation inactivates lymphocytes and prevents TA-GVHD. All cellular blood components should be irradiated including whole blood, red blood cells, platelets, and granulocytes. Leukocyte reduction by filtration does not remove sufficient numbers of lymphocytes to prevent graft versus host disease. Fresh frozen 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 could significantly elevate potassium levels in neonates and fetuses due to their small blood volume. This potential problem can be avoided by irradiating units just prior to transfusion. If unforeseen delays occur, the unit could be saline washed to remove potassium. Irradiated Blood Component Indications Established Indications:
Less well established indications:
Administration of irradiated products is the same as the administration of non-irradiated products. The cost of irradiation is highly variable depending on the type of irradiating device available. |
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