Nephrology

5111 Blood Component Transfusion- General Guidelines

  • Blood Component Transfusion- General Guidelines

    Recommendations of the Smith Report in paediatric blood transfusion at WCHCN

    The following criteria should be met

    1. Directed donation is clinically appropriate
    2. There is a significant likelihood of the child requiring transfusion during the planned procedure
    3. The parent will be able to supply all of the blood requirements for the procedure
    4. The ABO and Rh(D) group of the parent is compatible with that of the child
    5. The family is referred to ARCBS by RCH consultant
    6. The parent agrees to comply with the donor selection procedures employed by ARCBS, and fulfils all current donor selection criteria
    7. The parents who desire to provide directed donation for their child have received appropriate counselling and have given informed consent

    Risks Association with Family Donation

    Pressures for family members to donate blood may be intense and may lead to the concealment of information relating to risk behaviour that the questionnaire is designed to reveal. A well-completed confidential questionnaire is the key to a safe blood supply

    ABO incompatibility

    between potential family donors and recipients

    Rhesus incompatibility

    any girl receiving Rhesus positive blood from either parent, runs the risk of developing immunisation which could severely affect any future pregnancies and transfusions. This is a risk which could be evident in twenty years, but one which we must take account of now. 

    Any child receiving rhesus positive blood from the parent runs the risk of acute transfusion reaction if a subsequent transfusion is needed.

    HLA incompatibility

    This incompatibility can cause very severe lung disease Particularly in young children

    Graft versus host Disease

    Unless parental blood, or the blood of a close relative, is irradiated live cells from the parent can invade and severely damage the child. Irradiation is required for this blood to be safe.

    Blood from a relative can cause HLA antibodies to develop in the child. This means a family member's bone marrow is far less useful in a child with cancer. (The need for life saving bone marrow transplants will be required in approximately 1 in 3000 children.)