Does the Blood Bank require special documentation for blood product requests for stem cell transplant recipients?
No, this is not necessary. However, the information on the blood request form should clearly indicate that the patient is undergoing a peripheral stem cell transplant (PSCT) along with the ABO and Rh group of the donor, and to alert staff about any special requirements.
The Blood Bank staff will select blood products that are compatible with both the donor and recipient. With the exception of HLA-matched platelet products, it may take up to 3 days to find suitably matched blood for the recipient.
Leucocyte depleted red cell products are recommended to lessen sensitisation to transplant antigens and potential antibody formation. All infant and paediatric red cell concentrates are leucocyte depleted, but a specific request for leucocyte depletion should be made when ordering adult volume products for older children.
Gamma irradiation of platelet and red cell products is also important to prevent the cellular interaction between donor T lymphocytes and recipient cells that can result in transfusion associated Graft versus Host Disease (GvHD). From the time of initiation of the conditioning regimen, irradiated blood products should continue while the patient is on GvHD prophylaxis or lymphocytes are >1 x 109/l.
The following table serves as a guideline for component support in stem cell transplant recipients:
| Recipient | Donor | RBC | PLAPH, FFP | |
|---|---|---|---|---|
| ABO major | O
O O A B |
A B AB AB AB |
O O O A, O B, O |
A, AB B, AB AB AB AB |
| ABO minor | A
B AB AB AB |
O
O O A B |
O O O A, O B, O |
A, AB B, AB AB AB AB |
| ABO major and ABO minor | A
B |
B A |
O
O |
AB
AB |
In the event of a major incompatibility, the recipient will receive a stem cell transplant with a foreign antigen. In a minor incompatibility, the recipient will receive a stem cell transplant with a foreign antibody.
ABO titrations are available from the Blood Bank on request at R 202.98 inclusive VAT per titration (2022 price).
For more information, please contact your nearest Blood Bank.
