World Patient Safety Day on 17th September highlighted the need to prioritise and address safety in maternal and newborn care. As the blood service, we provide blood products and programmes specific for the needs of neonatal patients, as described below.
Under the Limited Donor Exposure Programme (LDEP), babies aged 0-4 months who undergo multiple transfusions can receive up to four packs of infant pre-storage leucocyte depleted red cell concentrates (35ml to 75ml) derived from a single adult pack. Reservation of these units limits the baby’s exposure to only one donor thereby reducing the risk of transmissible disease or alloimmunization. To select this service, ward staff should write ‘LDEP’ on the blood request form, or call the blood bank with this instruction. The clinician should instruct the blood bank how many units should be reserved for the baby. The presence of a maternal red cell antibody will preclude the use of LDEP products, as a full crossmatch will be necessary to find compatible blood products.
Leucocyte depleted whole blood for a neonatal exchange transfusion should be arranged with the blood bank and involves crossmatch testing against the neonatal and maternal blood sample. In the absence of a maternal sample, testing will continue using only the neonatal sample. On detection of an irregular red cell antibody, the blood bank will request additional maternal samples for antibody identification purposes and to facilitate future transfusions. Due to the relatively short product expiry of 24-hours, filtration of whole blood will commence after confirmation of the time of transfusion from the clinician.
A haemoconcentrate for intra-uterine transfusion must be arranged at least one day in advance with the blood bank. Orders should be placed before 13h00 and are not routinely available on Mondays, weekends or subsequent public holidays, as the blood must be no more than 72 hours old. In the event of an emergency, the senior clinical consultant can give permission to use older blood. On receipt of the blood request, our Immunohaematology Laboratory will perform the red cell antibody identification on the maternal sample, and may request additional samples, if necessary. On completion of the antibody identification, the blood bank will select a suitable unit of group O pre-storage leucocyte depleted red cell concentrate and confirm the haematocrit prior to commencement of crossmatch testing. Our Components Laboratory will wash the cells and process the pack into a haemoconcentrate, then return it to the blood bank for irradiation, and issuing to the patient.
For more information, please contact your nearest blood bank.