Hi

Can I ask some questions ?

1-For neonate for example his blood group AB and mother A or B when he needs  RBCs as mother blood group must we wash this unit to remove plasma from it or not and why ?

2-For neonate which is better many aliqouts from one donor (the same RBCs unit ) or different aliqouts from fresh RBCs units ?

3-For neonate which is better many thawed plasma from one donor ( the same plasma unit ) or FFP  units from different  donors ?

1.I prefer to use O washed blood  cells for neonate less than 4 month old

2.one donor

3. one donor is best, but it kind of difficult to do , since the plasma after thawing has shorter shelf life than red cells components

Edited April 23, 20187 yr by yan xia

We transfused with O pos or O neg less than 28 days from t he draw date unless it will be a large volume transfusion (greater than 60 ml per day), than its less than 5. If we do give non group  O red cells (direct donor) we perform a IgG crossmatch to make sure the baby doesn't have anti-A or anti-B from mom. The babies stay on the same unit until it is too old for neonatal use (>28 days)

The plasma we get from the supplier is AB and split in 4 aliquots of roughly  75 mls each

19 hours ago, yan xia said:

1.I prefer to use O washed blood  cells for neonate less than 4 month old

if group A or B must we wash it to remove the plasma or not ?

 

19 hours ago, yan xia said:

3. one donor is best, but it kind of difficult to do , since the plasma after thawing has shorter shelf life than red cells components

yes i know if we thaw FFP unit can we split it into aliqouts and stored in 1-6c and transfuse to neonate within the 5 days or better transfuse FFP from different donors ?

 

16 minutes ago, sherif said:

if group A or B must we wash it to remove the plasma or not ?

you said the baby is AB type, so the A or B donor must be washed.

Because the plasma will react with the red cells of the baby's.

Edited April 23, 20187 yr by yan xia

On 4/23/2018 at 10:53 PM, yan xia said:

you said the baby is AB type, so the A or B donor must be washed.

 

On 4/23/2018 at 10:53 PM, yan xia said:

Because the plasma will react with the red cells of the baby's.

thanks

Our policy is to issue O Group PRCs and group AB FFPs to a neonate (<4 months age). The Rh of PRCs will depend on the Rh status of the neonate. Top-up PRC transfusions are usually from one single unit <28 days.

If non-Group O red cells are transfused, verify that there isn't demonstrating anti-A, anti-B or anti-A,B in the baby.  Test reverse cells through Coombs phase or crossmatch the red cell unit.  To avoid the need to do this testing, transfuse Group O, Rh compatible red cells.

In my experience, it's best to limit donor exposure to the infant, if possible, for small volume transfusions.  Most facilities I have worked in dedicate a unit to the neonate from the first transfusion request until the unit expires or is used up.  CPDA or AS-, AS3 anticoagulant preferred - the fresher the unit when assigning to the baby, the longer it will last.  We also only assigned 2 babies per unit and aliquoted the desired volume from the original bag with each transfusion request as close as possible to the time of transfusion.  We only irradiated the aliquot ,not the original bag to avoid an increase in extracellular potassium that occurs after irradiation with storage.

 

7 hours ago, applejw said:

Test reverse cells through Coombs phase or crossmatch the red cell unit

explanation please ?

any answers ?

On 4/26/2018 at 4:43 PM, sherif said:

explanation please ?

To detect any circulating IgG component of anti-A, anti-B or Anti-A,B.

1-For neonate for example his blood group AB and mother A or B when he needs  RBCs as mother blood group must we wash this unit to remove plasma from it or not and why ?

We use O Neg, <7 days, CMV-, leukocyte reduced, Irradiated unit but we only use it up to 48 hrs post irrdaitaion. (Base don internal study to show that after 48 hrs the amount of potassium is significantly high which can adversely affect particularly low birth weight premie)

2-For neonate which is better many aliqouts from one donor (the same RBCs unit ) or different aliqouts from fresh RBCs units ?

In our case it will be different donor as we do not have irrdiator. Please see answer 1.

3-For neonate which is better many thawed plasma from one donor ( the same plasma unit ) or FFP  units from different  donors ?

We use only fresh frozen plasma so it will be only 24 hrs from thawing. Our blood supplier gives in small aliquots so we may end up using same donor. 

6 hours ago, Eagle Eye said:

1-For neonate for example his blood group AB and mother A or B when he needs  RBCs as mother blood group must we wash this unit to remove plasma from it or not and why ?

We use O Neg, <7 days, CMV-, leukocyte reduced, Irradiated unit but we only use it up to 48 hrs post irrdaitaion. (Base don internal study to show that after 48 hrs the amount of potassium is significantly high which can adversely affect particularly low birth weight premie)

2-For neonate which is better many aliqouts from one donor (the same RBCs unit ) or different aliqouts from fresh RBCs units ?

In our case it will be different donor as we do not have irrdiator. Please see answer 1.

3-For neonate which is better many thawed plasma from one donor ( the same plasma unit ) or FFP  units from different  donors ?

We use only fresh frozen plasma so it will be only 24 hrs from thawing. Our blood supplier gives in small aliquots so we may end up using same donor. 

thanks

@David Saikin

 

Does anyone have a policy that covers the use of FFP, PF24 and Thawed (5 day) plasma for neonates?  We use FFP that is one unit aliquoted into four pedi packs by our supplier and stored here frozen.  When needed we thaw one aliquot.  If we run out of it, can we safely use PF24 and aliquot it ourselves or even just hand out the whole unit for them to use part of.  While I am asking, I'll add 5 day plasma to the mix.  If you have an answer that covers other plasma products, feel free to include it.  I was thinking anything that is expected to have > 50% of factors VIII & V and Protein C would probably be adequate but we would like expert opinion.