Blood Products and Indications

For acute blood loss or to t Oi-carrying capacity if end-organ ischemia. In critical illness. Hb goal 7-9 g dl adequate; consider 70-12 g dl if coronary ischemia <NíjM 1999:340409 4 2001 ;345:1230). 1 U PRBC .! Hb by 1 g dl.Tx large # PRBCs can * i Ca & T K. Pits 10.000 pi or 20.000 p.l with infection or T bleeding risk or

50.000 p.l with active bleeding or preprocedure. Contraindicated in TTP HUS. HELLP. HIT. 6U - T pit count by 30-60.000 \i\. Refractory Í <-5000'pi 30-60 min posttransfusion. Suggests alloimmunization — trial ABO matched pits. If still refractory ✓ panel reactive Abs (PRA) to determine utility of HLA-matched pits. Contains all coagulation factors. For bleeding due to deficiency of multiple coagulation factors (e.g. DIC.TTP HUS. liver disease, warfarin exccss. dilution) or PT >17 sec preprocedure. Enriched for fibrinogen. vWF.VIII. and XIII. For bleeding in vWD. factor XIII deficiency or fibrinogen • 100 mg dl. Prevents donor T-cell proliferation in recipient. For Pts with risk of transfusion associated GVHD (HSCT. hematologic malignancies, congenital immunodeficiency).

From CMV-negative donors. For CMV-seronegative pregnant women, transplant candidates recipients. SCID. AIDS Pts. WBCs cause HLA alloimmunization and fever (cytokine release) and carry CMV. For chronically transfused Pts. potential transplant recipients, h o febrile nonhemolytic transfusion reaction, cases in which CMV-negative products are desired but unavailable. Polyvalent IgG from -1000 donors. For postexposure prophylaxis (e.g. HAV). certain autoimmune disorders (eg. ITP. Guillain-Barré. ? CIDP), congenital or acquired hypogammaglobulinemia (CVID, CLL). Removes Ig molec wt subst (eg, cryoglobulinemia. Goodpasture's, Guillain-Barré. hyperviscosity syndrome. TTP) or cells (eg. leukemia w hyperleukocytosis. sx thrombocytosis, sickle cell) from plasma.

Transfusion Complications

Noninfectious

Risk (per unit)

Infectious

Risk (per unit)

Febrile

1:100

CMV

common

Allergic

1:100

Hepatitis B

1:220.000

Delayed hemolytic

1:1000

Hepatitis C

1:1.600.000

Acute hemolytic

<1:250.000

HIV

1:1.800.000

Fatal hemolytic

<1:100.000

Bacteria (PRBCs)

1:500.000

TRAU

1:5000

Bacteria (platelets)

1:12,000

(NE/M 1999:340438; JAMA 2003:289 959)

(NE/M 1999:340438; JAMA 2003:289 959)

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