I just received a look back notice for some platelets we transfused to an oncology patient back in january. The donor apprently donated the pheresis unit during the 12 month deferral period for tissue transplants. My question is, this unit was probably full of HLA antibodies. The recipient has had subsequent febrile non hemolytic reactions to platelets. I am thinking that the unit in January may have caused it due to the HLA thing. What is everyone's opinion?

Thanks.

It's a possibility, I suppose. You were dealing with an oncology patient, and they are so predisposed to transfusion reactions due to their immune status. As QA, I never really had the time to investigate febrile reactions as much as I would have liked to. I always thought universal leukoreduction to be "the" answer to febrile reactions, but found out that this is not so. Oh, sure- it helped. But we still had febrile reactions.

I suspect that nearly 100% of our transfused patients undergo some type of reaction to transfusion, but most do not exhibit signs or symptoms that we recognize. After all, we are injecting a foreign substance in massive amounts into their bodies. Are we doing more harm than good by transfusing? There used to be no question about this. Now we are beginning to wonder.

BC

Hey Bob,

You back in the blood bank business or are the trains running a little slow lately? I've seen an increase in your posts and just wondering if you had returned to the fold.

John

John,

I still run a railroad for a living, but I consult for a blood bank on the side. Keeps me fresh.

Right now I am part of a team that is building a high speed railroad while a low speed (25 mph) railroad is running on the track. So, we shut down a piece of the railroad during the day while about 20 different contractors work on it, run freight trains on the rest of the railroad, and then run freight trains at night on the section under construction. We will run about 70 trains a day when we get things finished. I am over all train operations and I ensure that the contractors are following federal regulations (just like my blood bank work- can't get away from the feds, except that it is the FRA I deal with now instead of the FDA).

BC