The transfusion requirements of a patient are determined by clinical status and laboratory results. Transfusion decisions should take into account the clinical transfusion guidelines, modified to patient needs, and ensuring that the benefits outweigh the risks.
Informed consent must be obtained from the patient for all transfusions of blood or blood products.
In line with the Standards for Practice of Blood Transfusion in SA, no blood products may be issued without the signature of the Medical Practitioner on the Cross match Request Form or a person acting on his/her instructions. All patients’ details on the request form and specimen label must agree.
1. Red Cell Products
Red Cell Products should be stored between 1 oC - 6 oC
(a) Red Cell Concentrate in additive solution, Buffy coat removed
What is it used for:To increase tissue oxygenation due to reduced haemoglobin concentration.
b) Red Cell Concentrate (Leucodepleted)
What is it used for:To increase tissue oxygenation due to reduced haemoglobin concentration, when the recipient may receive repeated transfusions.
(c ) Red Cell Concentrate in additive solution
What is it used for: To increase tissue oxygenation due to reduced haemoglobin concentration.
(d) Red Cell Concentrate Paediatric (Leucodepleted)
What is it used for:To increase tissue oxygenation in paediatrics due to reduced haemoglobin concentration, when the recipient may receive repeated transfusions
2. Whole Blood (<5 days old)
(a) Whole Blood Leucodepleted ( <5 Days old)
What is it used for: Neonatal exchange transfusion.
3. Platelets products
Platelets should be used immediately after issue. They should not be refrigerated.
(a) Platelet Concentrate Pooled Non-leucodepleted
What is it used for:Thrombocytopaenia or platelet function abnormalities
(b) Platelet Concentrate Leucodepleted (Apheresis)
What is it used for: Thrombocytopaenia or platelet function abnormalities
(c) Platelet Concentrate Paediatric Leucodepleted
What is it used for: Thrombocytopaenia or platelet function abnormalities in paediatrics.
4. Plasma products
Donor retested - Issued only after subsequent donation from the same donor has been retested, and found negative for markers of transmissible diseases. MUST BE TRANSFUSED IMMEDIATELY AFTER ISSUE
What is it used for: Hypofibrinogenaemia and factor Xlll deficiency
(b) Fresh Frozen Plasma - Adult and Paediatric
What is it used for: For clotting factors
(c) FFP - (Cryo-poor)
What is it used for: TTP
Contact the blood bank. Advance notice is required.
For the prevention of transfusion-associated graft-versus host Disease
5. HLA-matched platelet concentrate
(single donor apheresis platelet concentrate
6. Other special services
Autologous and Directed Programmes
For trusfusion medicine consultation
Please contact the nearest Blood Bank for doctor on call
1. Prevention of transfusion transmitted CMV.
2. Potential haemopoietic transplant recipients.
3. Intrauterine transfusions and children <1 year of age.
4. Prevention of febrile non-haemolytic transfusion reactions.
Leucocyte deleted (leucodepleted) products
Filtered under laboratory conditions. This ensures optimal removal of leucocytes to minimise cytokine release. Leukocyte depletion will result in a leukocyte count of <5 x 106 per unit and usually <1 x 106 per unit.
Blood administration set: For the infusion of whole blood and red cell concentrate. Platelet administration set: For the infusion of platelets.
Blood pack without anticoagulant: For therapeutic bleeding.
Blood pack with anticoagulant: For blood salvage and subsequent autologous re-infusion.
Type of crossmatch
Type and Screen
The specimen will be grouped and tested to ensure that it does not contain antibodies which could delay finding compatible blood. The specimen will be held for 96 hours. Blood will only be cross-matched when requested by the attending doctor.
Standard Cross-match is done within 2 hours
Emergency cross-match requires 20 - 30 minutes
No cross-match requires 5 - 10 minutes
Blood issued on emergency or without compatibility test is transfused at the attending doctor's own responsibility. There are risks involved in emergency procedures - use them only for genuine emergencies.
Cross-matched products will be held in reserve for 24 hours unless otherwise indicated by the attending doctor.
Blood returnable basis (BRB)
Blood is transported in a temperature controlled hamper. Provided the blood is returned within 10 hours of issue, remains sealed in the hamper and the temperature of the hamper does not exceed 100 C, the fee for the blood will fall away. However, the service and laboratory test charge will be levied.
As with any treatment, the patient has the right to decide whether or not to accept the treatment. As far as possible the patient should understand the benefits, risks and alternatives to transfusion as explained by the prescribing doctor. Informed consent is a process which must be acknowledged and documented.