Thalassemia Patient Transfusion Requirements

[tlorme]

Can anyone tell me if they know of specific transfusion requirements for Thalassemia patients? We have 2 patients who are receiving frequent transfusion support, and the MD is requesting CMV neg, Irradiated, Double-washed PRBC's. I can't find any info on-line that speaks to this requirement for the patient population indicated. Thanks!

[Malcolm Needs ☆]

Apart from the normal things of making sure that the ABO group is compatible (!), that the Rh is negative for the antigens that the patients themselves lack, and K- (if the patient is K-), I have never heard of the need for CMV-, irradiated and, in particular, double washed (unless, of course, all of them are IgA deficient with anti-IgA).

Sounds like TOTAL overkill to me.

[Rh-fan]

I also never have heard about CMV neg and (double) wash.

In the soon to come new Dutch guidelines we also add Fya neg to the selection criteria (if the patient is Fya neg), because after Rh and K an anti Fya is the most common antibody seen in these patients (also for HBS patients). If the patient is not transfused recently we advise to do also Jk and Ss typing so we know which antibodies we can find in the future.

[Auntie-D]

We also transfuse the minimum number of units possible with the largest volume units to minimise donor exposure.

[Malcolm Needs ☆]

Agree absolutely Auntie-D.

[David Saikin]

We used to give retic rbcs - washed and only the very top portion of the untis were harvested for transfusion (usually about 150 cc). But that was the only reason we washed. Can't see the need, nor for CMV= or irradiated - these pts are not immunocompromised. Get your Medical Director or blood supplier MDs involved.

[Everett9239]

We give Rh-, K-, Fya- and HbS-, but we do not require irradiation or CMV-.

[donellda]

_{We give Rh-, K-, HbS- Adsol units.}

[tricore]

Is the double wash (2 liter wash?)intended to get rid of "marginal" cells and transfuse only the "freshest" cells? I assume the doctor is trying to transfuse the cells that will last the longest in the patient and to mitigate iron overload. Same as the retic rbcs mentioned by David. I have never heard of a requirement for CMV neg and irradiated for thalasemia patients unless this particular one is immunocompromised.

[rravkin@aol.com]

We also transfuse the minimum number of units possible with the largest volume units to minimise donor exposure.

Also to prevent potential iron overload.