med 18

 

412 Appendix C

Red Cell Products

Products Volume (mL) Shelf Life Advantages Disadvantages Comments

B. Sedimented RBCs

Hct 65%–80% (variable)

variable As above 1. Does not require

centrifugation

2. Contains less

plasma than standard RBC units

1. Hct may not be as

high as desired

An alternative to hardpacking without

centrifugation

C. Quad pack collection

Hct 55%–75%

Mother unit = 250–

350

Each satellite unit

≤150

1. CPD = 21 d

2. CPDA-1 = 35 d

3. AS = 42 d

1. Allows multiple

transfusions to one

infant

2. Volume of each

quad adjustable

1. Outdate rates high

unless NICU has

number of infants

2. Some wastage

expected

Many neonatal units

find this collection

system valuable if

they do not have

sterile connecting

equipment available.

D. Leukodepleted

RBCs

1. CPDA-1 = 250

2. AS = 350

Depends on anticoagulant-Preservative

solution as above

1. WBC count <1–5 ×

106

/product

2. Reduces risk of

transmission of

CMV

1. Prestorage LD preferred over bedside

filters

2. Cannot LD a unit

from sickle-trait

donor

3. Leukodepletion failures occur

1. Indicated for prevention of febrile transfusion reactions and

for leukocyte alloimmunization in older

children, but these

phenomena are rare

in neonates

2. Does not prevent

TA-GVHD

E. Washed RBCs 200 24 h 1. Removes 80%

WBCs

2. Removes platelets,

K, anticoagulant

3. Hct adjustable—less

viscosity

1. Time required for

preparation

2. Equipment not

always available

3. Expires 24 h after

washing as “open”

system

1. Can wash portions

of quad pack

2. May be combined

with FFP for

exchange transfusions.

3. Major indications

include patients

with hyperkalemia

and T activation

E. Irradiated PRBCs 1. CPDA-1 = 250

2. AS = 350

Depends on anticoagulant preservative

solution

1. Abrogates GVHD in

susceptible infants

1. Storage limited to 28

d postirradiation or

by original expiration

date due to K+

 leak

2. Equipment not

always available

1. Irradiation before

issue preferable to

long-term refrigerator storage postirradiation

F. Frozen deglycerolized RBCs

200 Frozen up to 10 yr

After thawing/deglycerolizing 24 h

1. Maintenance of 2,

3-DPG and ATP

2. Removes >80%

WBCs

1. Higher cost than

other preparations

2. Equipment not

always available

3. Expires 24 h after

washing

1. RBCs frozen with

glycerol, thawed, and

deglycerolized by

washing prior to transfusion, resuspended

in 0.9% NaCI

2. Allows storage of

rare types of blood

Table C.1 Blood Products (Continued)