Bone Marrow Transplant patient

[mawomack]

When the transplant takes place to you immediately change the patient's blood type so they get RBCs that are compatible with both the original and engrafted type? Or do you wait until the change in type takes place (engraftment)? What about for FFP and Platelet transfusions?

Mary Ann Womack, Florida Hospital

[Yanxia]

1.Yes.

2.FFP and platelet type is to ensure the antibody in it will not destroy the RBC .

[tjohnk1]

At the previous hospital I worked at, blood type isn't changed until engrafment takes place and there have been no transfusions for 3 months. This was decided because who knows if it is going to engraft successfully, if ever. A comment is put in stating Give O neg RBCS and AB plts/plasma or whatever type they need based on their transplant. Many of our patients got more than one transplant as well so it was unknown which one would work. HTH!

[labail]

at our institution we err on the side of caution and as soon as we know that the recipient has received an ABO mismatched bone marrow transplant, we start transfusing them the appropriate RBC type that is compatible with both, as well as FFP/plasma.

we also do type and screens on the inhouse patients every 3 days and watch for the conversion of blood types.

once fully converted, we change the patient's permanent blood type to the new transplanted blood type and make a notation that the patient used to be ____, received a bmt on ____, watch blood types carefully. on these patients, we also disallow electronic crossmatching.

[adiescast]

We wait for the type to change and match the type we transfuse to what we observe in the current testing. We have received patients who converted to a type different from that we were told they were transplanted with.

[Malcolm Needs ☆]

We wait for the type to change and match the type we transfuse to what we observe in the current testing. We have received patients who converted to a type different from that we were told they were transplanted with.

Were these, by any chance, patients who had been given stem cells from more than one cord donation at a time adiescast??

:confused::confused:

[adiescast]

I mentioned this in another thread. The patient was alleged to have received a double cord transplant. One cord was A Negative, the other was O Positive. The patient converted to B Positive. I don't remember the patient's original type. I think it was O.

[L106]

So......how did the patient become B Positive??.....

[adiescast]

I am assuming there was an error with one of the cord blood units, but I never got any acknowledgement from the transplant institution that they thought anything was odd about this. I didn't push it too hard.

[Malcolm Needs ☆]

I am assuming there was an error with one of the cord blood units, but I never got any acknowledgement from the transplant institution that they thought anything was odd about this. I didn't push it too hard.

Oh yes: I remember reading your post now.

:o:o

[sona]

what about the blood group changes?