Hi

I know we do not need to repeat antibody screen to infants less than 4 months old because they would not devolop new antibody.

So can we give D pos pletelat, FFP or RBC to D neg Infants?

Regards

Abid

Obviously, you have to honour any maternal antibodies that have been transferred to the baby's circulation, but, as you say, no "new" antibodies should be produced. The problem is, however, that not all babies have read the books, and the occasional baby will have a "precocious" immune system, and will produce de novo antibodies, so giving D+ blood components to a D- baby is not a great idea, unless it cannot be avoided.

All that having been said, there is a theory that, if an antigen is introduced to a baby's immune system early enough, the baby will become tolerant to the antigen and never produce an antibody against an antigen. I do not know enough about immunology to dispute this, but I would be very hesitant to "experiment" by purposely giving a D- baby D+ blood components, especially a female D- baby. Could turn out to be very expensive in court!

For rbc ,it may be a risk ,for plts how much of quntity of rbc can be there which may be problem for RES of the infant but FFP whats the fun of considering RH when there are no rbcs and D is not found on plt and wbc...hope it helps

Yep, couldn't disagree with that irshadaad.

An RBC's lifespan is 120 days so, depending on the baby's age when transfused, the D+ RBCs could still be present when the immune system starts to wake up.

Yes,that is a very good reason NOT to transfuse a D+ PRBCs or Platelets to a neonate.

I agree with that Mabel Adams.

Correction! I mean to a D Negative Neonate,sorry for that.

There are reported cases of babies producing antibodies. So do follow the standards.

We respect the D status for plts as there was s dicussion here about the rbcs in a plt conc, I would hate to bring up the strong and heated discussion again.

Malcolm, about tolerance, it is true but to my knowledge that occurs at the fetal stage.

If it is unavoidable to transfuse Rh+ plt to Rh neg, RhIG should be considered in adult patients.(AABB)

However for infents the doctor should makes the decision !?

I would agree with keeping strictly to an Rh D match for Rh D neg babies, for all the reasons stated above.

Ref the point about platelets not containing any red cells - yes it is true that component donation platelets (ie apheresis) have extremely low levels of red cell contamination, but remember that QA standards are that only a percentage of components are tested to confirm this, and only 75% of those tested are required to conform to specification - I certainly wouldn't take the risk of transfusing RhD pos platelets to a RhD neg baby unless I really had no other option.

It's a shame that the Regulations don't allow us to remove the RhD type completely from labels of FFP packs, as that is one case where it really doesn't matter.

Edited December 1, 201113 yr by Tonyd

For female recipients before or within the reproductive age, and with reproductive possibilities (no hysterectomy, etc..), D neg platelets to D neg patients.

See below - I hit the wrong button!

Actually Tony, I hate to say this, but some commercially available pooled FFP in Europe does no longer carry the RhD type, or the ABO type, come to that.

Actually Tony, I hate to say this, but some commercially available pooled FFP in Europe does no longer carry the RhD type, or the ABO type, come to that.

Very true Malcolm, but that is because the particular FFP of which you speak is not classed as a blood component, and so does not fall under the requirements of the BSQR.

It is a pharmaceutical blood product, ie a medicine, and comes under the provisions of the Medicines Act in the UK, which does not mandate blood group labelling requirements - again it is why it appears in the British National Formulary, whereas blood components do not.

Best wishes

Tony

I didn't know that. Wonder who thought that one up. Bit semantic isn't it?????????!!!!!!!!!!!!!!!

I didn't know that. Wonder who thought that one up. Bit semantic isn't it?????????!!!!!!!!!!!!!!!

Tell me about it !