Clinical Laboratory - Transfusion Medicine
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Blood Product Modification
Leukoreduction can be accomplished with frozen, deglycerolized units of RBCs. Leukoreduction filters to remove leukocytes are not completely effective. Gamm irradiation is expensive, but will kill the nucleated cells (lymphocytes) that could cause TAGVD.
PRBCs can be further specialized depending on the indication, such as if agents need to be reduced or removed from the unit. These include:
Washed Red Blood Cells: A unit of packed red blood cells (PRBCs) is washed to reduce plasma proteins. This reduces the risk for allergic transfusion reactions. Washing reduces immunoglobulins, such as anti-IgA that could cause anaphylactic transfusion reactions in persons with selective IgA deficiency.
Leukocyte Reduced: Red blood cell and platelet units may be filtered to remove most of the leukocytes (white blood cells). This may reduce the risk for febrile transfusion reactions, may help prevent alloimmunizaton to MHC (HLA) donor antigens, and help reduce the risk for cytomegalovirus (CMV) infection.
Irradiated Blood: Irradiation is needed to destroy all nucleated cells and living leukocytes (white blood cells), particularly lymphocytes that could cause transfusion associated graft versus host disease (TAGVD).